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THE 


ANGLE  SYSTEM 


OF 


R^(5ulaHo9 


«9[)d 


OF  THE  TEETH. 


THIRD  EDITION,  REVISED  AND  ENLARGED. 


s  1 9 


BY 


I)  C  ' 

EDWARD  H.  ANGLE,  D.D.S., 

Former  Professor  of  Histology  and  Orthodontia,  and  Comparative 
Anatomy  of  the  Teeth,  in  the  Dental  Department  of  the 

University  of  Minnesota. 


PUBLISHED  BY 

The  Wilmington  Dental  Manufacturing  Company, 
1413  Filbert  Street,  Philadelphia,  Pa. 

1892, 


Dr.  B^rnh(^rd  W.  Weinberger 
119  West  67th  St,i  New  York 


^ITTIIT' 


PROGf^ESSlVE  DEfiTISTS 


]y[UST  have  a  progressive  magazine,  in  order  to  be  able  to  be  abreast 
with  all  the  new  ideas  coming  up  in  theory  or  practice. 

This  is  the  reason  why  The  Items  oe  Interest 
has  been  so  largely  indorsed  at  home  and  abroad 
by  the  busy  profession.  We  have  been  gather¬ 
ing  our  original  information  from  authorities 
on  various  subjects  of  every-day  practice,  and 
also  from  foreign  sources  almost  inaccessible 
to  any  other  of  our  esteemed  contemporaries. 

But  we  have  not  confined  ourselves  to  the 
following  of  the  requirements  of  the  present 
state  of  the  dental  field.  We  have  learned  to 
follow,  in  order  to  be  able  to  lead  better,  and  so 
we  have  made 

A  NEW  DEPARTURE 

in  dental  jourpalism,  and  will  present  during  the  great 
“  Columbian”  year,  1893,  a  series  of  articles  on  Diseases 
of  the  Mouth,  by  W.  F.  Rehfuss,  D.D.S  ,  author  of  “  Den¬ 
tal  Jurisprudence,”  and  L.  Bnnkmann,  M.  D, ,  which  introduce 
important  contributions  to  that  particular  branch  of  dentistry, 
and  at  the  same  time  bring  an  innovation  which  will,  no  doubt, 
be  welcomed  by  the  professors,  students  and  practitioners. 

CHROMO=LITHOQRAPHIC  ILLUSTRATIONS. 

The  articles  will  be  accompanied  by  chromo-lithographic  plates, 
illustrating  each  case  in  the  natural  colorings,  and  painted  by  the 
authors  from  practice.  Such  plates  have  never  been  ])ublished  before. 

There  is  a  rare  opportunity  offered  to  all  dentists  and  students  to 
obtain  a  complete  work  on  oral  diseases,  richly  illustrated,  for  the 
exceptionally  low  price  of  a  year’s  subscription  to  The  Items  OE 
Interest,  which  is  only  one  dollar. 

.  OUR  AIM. 

Our  aim  being  to  follow  in  the  lines  of  progress,  we  can  only 
hope  that  our  efforts  on  behalf  of  the  profession  will  be  appre¬ 
ciated,  and  that,  the  subscription  lists  being  ever  increased, 
we  will  thus  be  able  to  perform  our  important  task  still 
better ;  and  we  can  confidently  lead  dentists  and 
students  to  expect  even  greater  surprises  in  the 
year  1894. 

Doctor,  subscribe  for  your  maga¬ 
zine  now  ! 


THE  WILmiNCTON  DENTHL  M’F’G  CO., 

PHILADELPHIA,  HEW  TOBK,  OHIOAOO,  WASHIN&TON,  WILMINQTOH. 


ANGLE  SYSTEM 


OF 

Regulation  and  Retention 

OF  THE  TEETH. 


THIRD  EDITION,  REVISED  AND  ENLARGED. 


—  BY — 


EDWARD  IT.  ANGLE,  D.D.S., 

Former  Professor  of  Histology  and  Orthodontia,  and  Comparative  Anatomy  of  the 
Teeth  in  the  Dental  Department  of  the  University  of  Minnesota. 


PUBLISHED  BY 

The  Wilmington  Dental  Manufacturing  Co,, 
1413  Filbert  Street,  Philadelphia,  Pa, 

1892. 


Copyrighted,  1892,  by  Edward  H.  Angle,  D.D.S.,  Minneapolis,  Minn. 


CONTENTS. 


CHAPTER  I. 

^l. — Angle’s  Regulating  and  Retaining  Appliances,  Set  No.  1.  .  .  3 

1 2. —  Fundamental  Principles .  G 

^3. — Rotation . IG 

|4. — Double  Rotation .  17 

^5. — Backward  in  the  Line  of  the  Arch .  18 

^G. — Forward  “  “  “  “  .  20 

|7. — Outward .  20 

|8. — Expansion.  .  . .  22 

§9. — Inward.  .  . .  24 

_  «  _ 

^10. —  Elongation  or  Forcible  Eruption  .  . .  25 

CHAPTER  II. 

'^11. — Angle’s  Regulating  and  Retaining  Appliances,  Set  No.  2.  .  .  3G 

§12. — Expansion .  45 

§13. — Outward .  47 

§14. — Elongation . 47 

§15. — Inward .  47 

CHAPTER  III. 

Einal  Suggestions.  . .  48 


CHAPTEK  I. 


§1. — Angle’s  System  of  Eegulating  and  Eetaining 

Appliances,  Set  No.  1. 

TT7E  frequently  see  it  stated  by  writers,  and  some  who 
^  ^  would  like  to  be  considered  an  authority  on  the  treat¬ 
ment  of  dental  irregularities,  that  no  fixed  system  of  appliances 
should  be  depended  upon,  but  an  appliance  invented  to  suit 
the  requirements  of  each  case. 

We  know  that  these  statements  are  erroneous,  and  are 
undoubtedly  productive  of  much  harm,  for  they  serve  only  to 
prevent  system  and  progress.  And  such  assertions  cannot 
fail  in  time  to  react  on  their  authors.  For  they  will  be  quoted 
by  future  writers  to  illustrate  how  defective  was  their  knowl¬ 
edge  of  the  subject. 

We  know  that  it  is  possible,  practical,  and  even  easy,  to 
so  systematize  and  classify  appliances  to  a  few  simple  forms, 
as  to  meet  the  requirements  of  all  varieties  of  cases  which  are 
susceptible  of  treatment. 

In  proof  of  which  we  submit  this  system,  and  as  further 
evidence  invite  inspection  of  our  private  collection  of  models 
of  cases,  which  correctly  show  each  stage  of  the  operation 
from  beginning  to  completion,  in  the  treatment  of  which,  in 
no  instance  did  we  use  other  than  the  appliances  shown  in  the 
Sets  Nos.  1  and  2,  and  in  only  but  few  instances  did  we  find  it 
necessary  to  use  other  combinations  of  the  appliances  than 
those  shown  hereafter,  and  for  variety  and  results  we  believe 
this  collection  will  compare  with  any  other  one  in  the  world. 

We  know  that  to  attempt  to  convince  those  long  accus¬ 
tomed  to  the  plan  of  devising  clumsy  and  unscientific  aj^pli- 
ances  for  each  case,  that  it  is  possible  to  so  systematize  and 

3 


4 


classify  appliances  to  meet  all  requirements,  will  meet  with 
little  favor. 

Blit  when  the  time  comes  that  teachers  will  recognize 
that  it  is  not  only  possible,  but  most  practical,  it  will  be  as 
easy  for  students  to  become  proficient  in  this  important  branch 
as  that  of  operative  dentistry,  or  any  of  the  different  branches 
now  so  successfully  taught  in  our  colleges.  But  the  present 
plan  of  attempting  to  make  proficient  practitioners  in  ortho¬ 
dontia  by  teaching  them  to  be  inventors  of,  or  selectors  of, 
appliances  from  the  chaotic  profusion,  many  of  which  are  only 
duplicates  of  others  in  principle,  serves  only  to  eonfuse,  and 
must  always  result  in  the  graduate  knowing  comparatively 
little  about  the  subject,  and  being  unqualified  to  seientifically 
and  successfully  treat  cases. 

We  believe  that  there  is  no  branch,  which  is  so  unscien¬ 
tifically  taught,  as  is  orthodontia  to-day. 

Much  time  is  devoted  by  some  colleges  to  the  manufac¬ 
ture  of  appliances  by  the  students,  but  w^e  believe  that  the 
time  could  be  far  more  profitably  spent  in  real  clinical  prac¬ 
tice,  in  which  the  student  shall  carefully  study  cases  and  make 
apiDlication  of  established  forms  of  instruments,  which  have 
been  made  by  experts  and  are  far  more  perfect  than  he  could 
ever  do  himself,  just  the  same  as  he  now  makes  use  of  in¬ 
struments  in  other  branches  of  dentistry. 

Dr.  Farrar  seems  also  to  have  become  convinced  of  the 
practicability  of  what  I  have  already  stated,  for  he  says  in 
Yol.  XX,  page  20,  of  the  Dental  Cosmos: 

“  Tt  has  for  some  time  been  evident  to  me  (though  by 
most  people  thought  to  be  impracticable),  that  the  time  will 
come  when  the  regulating  process  and  the  necessary  apparatus 
will  be  so  systematized  and  simplified  that  the  latter  will 
actually  be  kept  in  stock,  in  parts  and  wholes,  at  dental  de¬ 
pots,  in  readiness  for  the  profession  at  large,  so  that  it  may  be 
ordered  by  catalogued  numbers  to  suit  the  needs  of  any  case. 
So  that  by  a  few  moments’  work  at  the  blow-pipe  in  the  lab¬ 
oratory,  the  dentist  may  be  able  by  uniting  the  parts  to  pro- 


Health  Scicrcec  !  ibrar\'  Chapel  Hill 


I 

tj 

duce  anj  apparatus,  of  any  size  desired,  at  minimum  cost  of 
time  and  money.” 


In  preparing  tlie  third  revised  treatise  on  this  system,  I 
have  but  few  changes  to  make  in  the  appliances,  although  they 
have  been  subjected  to  many  severe  tests  in  the  treatment  of  a 
large  number  of  cases,  many  of  which  were  most  difficult. 
Yet  we  have  found  that  the  number  of  pieces  has  fully  met 
all  the  requirements,  and  the  sizes  and  shapes  are  so  perfect, 
that  we  question  whether  they  will  ever  be  changed  for  the 
better. 

The  coils  of  band  material,  “F”  and  “H”  are  now  made 
thinner;  the  former  being  .003  and  the  latter  .004  inches  in 
thickness,  which  we  have  found  quite  sufficient  to  stand  the 
necessary  strain.  And  the  delicate  temper  of  the  screws, 
which  is  so  important,  as  well  as  the  careful  proportions  of 
the  material  in  the  sheath,  have  been  brought  to  the  greatest 
perfection. 

But  most  important  is  the  extreme  accuracy  with  which 
the  seamless  tubes  fit  all  the  different  parts  passing  through 
them.  This  state  of  perfection  has  only  been  reached  by  much 
careful  experimenting,  and  more  perfect  machinery  for  their 
manufacture. 


6 


We  are  thorough ly  convinced  that  the  attempt  of  dentists 
to  make  the  appliances  for  their  own  cases,  is  a  serious  mistake, 
as  many  of  the  possibilities  in  their  use  will  be  defeated.  Per¬ 
haps  no  other  instruments  used  by  dentists  are  subjected  to  such 
severe  tests  as  the  regulating  appliance.  As  well  might  the 
dentist  attempt  the  manufacture  of  the  fine  pluggers  for  pack¬ 
ing  gold;  a  practice  abandoned  long  ago  by  most.  And 
although  many  may  not  now  agree  with  me  in  regard  to  the 
manufacture  of  regulating  appliances,  yet  I  fully  believe  that 
the  time  will  soon  come  when  this  will  be  acknowledged  true. 

In  the  application  of  the  appliances,  experience  has  de¬ 
veloped  many  quicker  and  simpler  ways  of  adjusting  them, 
as  well  as  better  and  more  efficient  combinations,  which  will 
be  shown  later  on. 

And  finally,  we  have  added  the  very  useful  adjunct,  viz.^ 
the  clamp  band,  shown  in  Figures  7  and  8,  and  which  are  so 
quick  and  easy  of  application,  and  their  use  so  satisfactory, 
that  they  will  be  greatly  appreciated  by  all  who  use  them. 

It  is  not  my  intention  at  this  time  to  give  a  full  and 
complete  treatise  on  orthodontia,  but  rather  to  give  my  own 
method  of  accomplishing  the  different  movements  in  the  cor¬ 
rect  adjustment  of  malposed  teeth,  believing  that  most  prac¬ 
titioners  will  succeed  far  better  by  adopting  one  method,  and 
thoroughly  familiarizing  themselves  with  the  principles  of  the 
same,  than  they  will  by  but  a  general  understanding  of  the 
almost  innumerable  methods  and  appliances  which  have  been 
brought  out  from  time  to  time. 

To  those  who  wish  to  pursue  the  subject  as  to  the  Etiol¬ 
ogy,  together  with  the  history  of  methods  and  appliances  in 
general,  I  would  recommend  the  excellent  works  on  the  sub¬ 
ject  by  Drs.  Guilford  and  Kingsley. 

§  2. — Fundamental  Principles. 

In  studying  the  construction  and  application  of  any  sys¬ 
tem,  having  for  its  object  the  treatment  of  dental  irregularities, 
the  fundamental  principles  will  be  more  easily  understood,  if 


7 


we  remember  that  the  movements  in  regulating  are  limited  to 
one  or  more  of  the  following : 

Forward  in  line  of  arch  ;  backward  in  line  of  arch ; 
from  without,  inward  ;  from  within,  outward ;  rotation,  and 
occasionally  elongation  or  depression.  The  physiological 
principles  governing  all  these  movements  are  the  same,  so 
that  by  understanding  the  principles  governing  one,  we  may 
comprehend  all. 

In  applying  force  to  a  tooth,  it  should  be  direct,  and  suf¬ 
ficient  to  accomplish  the  desired  movement  as  rapidly  as  is 
consistent  with  the  physiological  law,  governing  the  absorp¬ 
tion  of  bone  in  each  case.  This  law  varies  so  greatly  with 
different  individuals,  and  at  different  ages,  that  no  fixed  rate 
can  ever  be  established.  The  judgment  of  the  operator  must 
determine.  But  in  no  instance  must  the  pressure  exerted  be 
great  enough  to  occasion  pain ;  if  so,  the  normal  rate  of  ab¬ 
sorption  is  interfered  with. 

A  very  safe  rule  to  apply,  whether  the  pressure  be  con¬ 
stant  or  irregular,  is  to  see  that  it  in  no  instance  exceeds  a 
snug  feeling.  I  am  convinced  that  this  feeling  is  the  true  in¬ 
dication  of  the  proper  amount  of  force. 

Another  very  important  principle  which  should  always 
be  borne  in  mind  while  performing  the  movements  of  a  tooth 
is,  that  pressure  should  never  be  wholly  relinquished. 

The  movements  of  a  tooth  may  be  arrested  as  often 
as  is  necessary,  but  never  allowed  by  reason  of  removal  of 
pressure,  to  spring  backward,  thus  interfering  with  tire  process 
of  repair. 

I  am  convinced,  that  disregarding  this  principle  (as  has 
usually  been  necessary  in  the  ordinary  regulating  appliances,, 
by  reason  of  the  faulty  principles  on  which  their  construction 
has  been  based,  necessitating  their  frequent  removal  for  pur¬ 
poses  of  modification  and  cleansing)  has  been  the  occasion  of 
nearly  all  the  pain  and  soreness  in  regulating. 

The  result  of  this,  in  many  cases,  has  been  discourage¬ 
ment  on  the  part  of  the  patient,  and  much  annoyance  and 


8 


* 


frequent  failure  on  tire  part  of  tire  operator.  The  movement 
of  a  tooth,  if  intelligently  accomplished,  is  painless. 

Another  very  important  principle  to  be  remembered  is, 
that  support  and  perfect  rest  are  essential  to  a  tooth  after  it 
has  been  moved  into  the  desired  position. 

Any  appliance  for  retaining  a  tooth,  which  necessitates 
its  frequent  removal,  should  never  be  used,  except  in  those 
cases  represented  by  Fig.  48.  Again,  a  retaining  appliance 
should  be  so  delicate,  that  it  may  be  worn  without  inconveni¬ 
ence  to  the  patient,  until  perfect  firmness  has  been  established, 
and  should  never  be  under  the  control  of  the  patient.  It 
may  be  needless  to  remark,  that  a  tooth  so  retained,  will 
become  firm  in  its  new  position  much  more  speedily  than  if 
subjected  to  occasional  disturbances.  It  is  believed  that  the 
following  system  of  treating  dental  irregularities  enables  the 
intelligent  operator  to  easily  fulfill  the  requirements  so  far' 
enumerated. 

In  deciding  upon  a  proper  course  of  treatment  in  any 
given  case,  much  care  and  judgment  should  always  be  exer¬ 
cised,  besides  a  careful  study  of  the  features  and  the  due  con¬ 
sideration  of  the  probable  modifying  effects  of  the  proposed 
changes,  the  establishment  of  correct  occlusion,  etc. 

A  valuable  assistance  will  always  be  found  in  first  obtain¬ 
ing  very  accurate  models  of  both  jaws,  and  correctly  articu¬ 
lating  the  same. 

Such  models  not  only  assist  in  forming  a  basis  for  correctly 
establishing  the  proper  line  of  operation,  but  are  exceedingly 
valuable  as  reference  during  the  whole  course  of  treatment, 
for,  from  such  models,  accurate  measurements  may  be  taken 
from  time  to  time,  and  comparisons  may  be  made  with  the 
teeth  as  the  case  progresses. 

In  this  way  we  may  not  only  judge  of  the  exact  speed 
of  the  moving  teeth,  but  unfavorable  movements  of  the  anchor 
teeth  may  be  detected. 

In  order  that  these  models  may  be  of  any  value,  they 
must  not  only  accurately  show  the  positions  of  the  teeth  and 


9 


•cusps,  but  tliej  must  also  indicate  the  rugge,  gums,  and  as 
much  of  the  roots  and  positions  of  the  same  as  indicated  by 
the  gums  and  alveoli,  un  to  the  point  where  the  attachments 
of  the  muscles  render  obscure  the  further  shape  of  the  jaw. 

From  the  large  number  of  imperfect  models  which  I 
have  received  from  dentists,  I  am  of  the  opinion  that  the 
value  of  correct  models  is  not  siifhcientlj  appreciated. 

After  trying  all  kinds  of  impression  materials  and  differ¬ 
ent  methods  of  taking  impressions,  I  am  well  satisfied  that  the 
best  material  is  Teague’s  Impression  Compound  or  Plaster, 
and  it  should  be  used  as  follows : 


In  the  first  place,  the  impression  cups  for  sale  at  the  dif¬ 
ferent  dental  depots  are  all  incorrect  and  ill- adapted  to  the 
purpose  of  obtaining  impressions  of  a  jaw  containing  full 
dentures,  for  the  reason  that  they  are  intended  for  taking 


10 


impressions  of  edentalons  jaws.  Tlie  rim  of  tliese  cups,  as- 
well  as  the  portions  covering  the  palatine  process,  are  entirely 
too  low  ;  they  should  be  much  higher. 

By  obtaining  a  few  sizes  of  the  cups,  as  represented  in 
Fig.  2,  the  difficulty  of  taking  impressions  high  or  low 
(depending  whether  it  be  the  upper  or  lower  jaw)  is  wholly 
obviated. 

When  a  cup  suitable  to  the  case  has  been  selected,  it 
should  be  slightly  oiled  or  coated  with  a  film  of  fine  castile 
soap,  which  can  be  easily  accomplished  by  moistening  a  small 
pledget  of  clean  cotton  in  water,  rubbing  it  over  a  piece  of 
castile  soap,  and  then  over  the  cup. 

When  the  impression  plaster  has  been  mixed  to  the  usual 
consistency,  and  distributed  in  the  cups  nearly  as  it  should 
appear  after  the  impression  is  taken,  and  the  patient  provided 
with  a  clean  towel  about  the  neck,  has  been  instructed  to  sit 
upright,  the  mouth  is  opened  and  the  cup  .inserted.  The  head 
should  be  somewhat  thrown  forward  to  prevent  the  plaster 
from  falling  into  the  throat.  The  cup  should  be  pushed  up 
first  at  the  heel,  then  the  lips  raised  and  the  anterior  part  of 
the  cup  forced  well  into  position ;  then  the  lips  should  be 
drawn  down  wmll  over  the  edge  of  the  cup,  and  a  slight  pres¬ 
sure  exerted  from  the  outside,  in  order  to  force  the  plaster 
well  up  against  the  muscles.  The  plaster  should  be  allowed 
to  become  hard  and  thoroughly  set,  after  which  the  cup  and 
all  surplus  pieces  of  plaster  should  be  carefully  removed, 
leaving  the  impression  still  in  the  mouth.  With  the  blade 
of  a  penknife  cut  two  grooves  in  the  impression,  the  posi¬ 
tion  of  the  grooves  being  parallel  to  the  lines  of  the  axis  of 
the  cuspid  teeth.  These  grooves  should  be  quite  deep,  but 
not  entirely  through  the  impression  to  the  gums  or  to  the 
crowns. 

This  being  done,  the  point  of  the  penknife  should  be  in¬ 
serted  in  one  of  the  grooves,  and,  with  a  quick  pry,  the  exter¬ 
nal  plate  of  the  plaster  between  the  grooves  is  removed.  The 
plates  at  the  sides  can  now  be  broken  outward  between  the 


11 


thumb  and  finger,  the  line  of  fracture  will  follow  the  cutting 
edges  of  the  teeth,  then  the  large  piece  of  plaster  covering 
the  roof  of  the  mouth  is  readily  worked  loose  and  removed 
in  one  piece. 

If  the  operation  has  been  carefully  performed,  the  im¬ 
pression  will  consist  of  but  four  pieces. 

After  drying  a  few  moments,  they  are  easily  replaced  in 
their  proper  positions  in  the  order  in  which  they  were  re¬ 
moved,  and  secured  by  wax,  or,  better  still,  moistening  the 
edges  of  the  fracture  with  celluloid,  dissolved  in  ether,  as 
suggested  by  Dr.  Van  Duzee. 


Fig.  3. — Impression  Reunited. 


Nevei^  attewjpt  to  reunite  the  'pieces  by  replacing  in  the 

caps. 

The  impression  should  now  appear  as  shown  in  Fig.  8. 


12 


Not  longer  tlian  one-halt  hour  after  the  impression  has 
been  taken,  the  inside  should  be  thoroughly  coated  with 
shellac  varnish ;  at  the  expiration  of  another  half  hour  it  is 
again  coated  with  sandaric  varnish,  and,  at  the  end  of  still 
another  half  hour,  it  should  be  very  carefully  filled  with 
plaster,  and  turned  upside  down  on  a  glass  slab. 

‘After  the  plaster  is  thoroughly  set,  the  pieces  of  the  im¬ 
pression  may  be  usually  very  readily  separated  in  the  same 
order  in  which  they  were  removed  from  the  mouth. 

The  model  can  now  be  trimmed,  and  not  only  will  ther® 
be  a  surface  as  smooth  as  the  most  finely  polished  marble,  but 
each  cusp  and  all  the  interdental  spaces,  as  well  as  the  rugge, 
and  even  the  minute  “stipples”  of  the  gum,  will  be  most 
accurately  and  beautifully  shown.  The  models  should  now 
be  neatly  labeled  and  will  serve  all  the  purpose  of  study  and 
reference,  besides  being  valuable  as  legal  evidence. 

W e  now  come  to  another  most  important  principle,  which 
should  be  remembered  in  the  movement  of  a  tooth,  viz. :  that 
correct  or  stationary  anchorage  should  be  secured  when  possi¬ 
ble. 

Teeth  that  have  been  selected  as  anchorage  should  be 
attached  in  such  a  manner  that  tipping  and  consequent  move¬ 
ment  would  be  impossible,  or  if  movement  of  such  a  tooth 
does  take  place,  the  anchorage  should  be  so  rigid  that  the 
tooth  must  be  dragged  bodily  through  the  alveolus,  the  apices 
of  the  root  moving  fully  as  much  as  the  crown. 

This  principle  is  well  illustrated  in  Fig.  4,  in  which  the 

anchor  teeth  are  banded,  and  a  pipe 
or  sheath,  through  which  the  screw 
pulls,  is  rigidly  attached  by  means 
of  solder  as  the  band  on  the  anchor 
teeth  is  firmly  cemented.  It  will 
be  seen  that  perfect  anchorage  is 
Fig.  4.— stationary  Anchorage,  established  and  Consequent  tipping 

•of  the  tooth  rendered  impossible. 


18 


The  dotted  lines  in  the 
diagram  indicate  the  move¬ 
ments  which  must  take  place. 

Fig.  5  shows  the  same  prin¬ 
ciple  where  the  motion  is  push¬ 
ing  instead  of  pulling.  The 
base  of  the  jack-screw  in  this 
case  is  soldered  to  the  band. 

It  will  be  readily  compre¬ 
hended  how  greatl}^  anchorage  will  be  increased,  when  advan¬ 
tage  is  taken  of  this  method  over  the  old.* 

Figure  1,  Angle’s  appliances,  shows  the  simple  appli¬ 
ances  from  which  all  the  various  combinations  used  in  this 
system  are  made.  “A”  is  a  large  traction  screw  encased  in  its 
accompanying  tube,  and  used  for  pulling  where  resistance  is 
great.  “  B  ”  is  a  smaller  traction  screw  used  in  the  same  way, 
where  resistance  is  slight,  or  where,  from  any  reasou,  a  delicate 
appliance  is  desired.  “C”  and  “D”  are  tubes  which  are  sol¬ 
dered  to  the  bands  placed  upon  the  teeth  to  be  moved,  into 
which  the  ends  of  the  traction  screw  are  hooked.  “  J”  is  a 
jack-screw  encased  in  a  sheath  and  used  for  pushing.  “E” 
is  an  extra  sheath,  by  means  of  which  a  longer  jack-screw  can 
be  made.  “  F  ”  and  “  11  ”  are  coils  of  band  material  of  different 
thickness.  “G”  is  gold  wire  used  in  retaining  the  teeth,  after 
they  have  been  moved  into  the  desired  positions ;  also  to  assist 
in  securing  an  anchorage  in  some  cases.  “E,”  are  small  re- 

O  C 

taining  tubes  designed  to  be  soldered  to  bands  into  which  the 
retaining  wire  fits  accurately.  “  L”  are  piano- wire  levers  of 
varying  sizes,  giving  different  degrees  of  power. 

It  will  thus  be  seen  that  the  appliances  are  very  simple 
and  few  in  number,  being  limited  practically  to  three,  viz. : 
the  lever  for  rotating,  the  screw  for  ^Dushing,  and  the  traction 
screw  for  pulling ;  the  other  pieces  being  for  the  purpose  of 

*  I  am  indebted  to  Dr.  W.  C.  Barrett  for  first  suggesting  the  possibility 
of  this  method  of  anchorage,  from  which  I  have  derived  so  much  advantage 
and  find  so  applicable  to  this  system. 


14 


securing  attachments,  and  aside  from  the  advantages  of  sim¬ 
plicity,  efidciency,  and  cleanliness,  stationary  anchorage,  non¬ 
relinquishment  of  pressure,  and  firm  retention  may  he  easily 
accomplished  by  their  intelligent  application. 

As  it  will  be  seen  that  the  plain  band  plays  so  important  a 
role  in  attaching  the  different  parts  of  the  appliances  to  the 
teeth,  *I  will  here  describe  the  quickest,  easiest  and  most  accu¬ 
rate  way  of  making  and  setting  these  bands. 

First,  the  rubber- dam  should  be  slipped  over  the  tooth 
to  be  banded,  and  at  least  one  more  on  each  side,  and  it  is 
usually  better  to  include  all  the  teeth  to  which  the  appliance 
is  being  adjusted.  The  surface  of  the  tooth  to  be  banded  is 
then  carefully  cleaned  by  means  of  a  pledget  of  cotton  moistened 
in  alcohol  or  ether.  A  loop  of  the  band  material  is  then  slipped 
over  the  tooth. 

I  prefer  German  silver  to  any  other  metal,  on  account  of 

its  great  strength.  It  can  be  rolled  to 
extreme  thinness,  thereby  occupying 
the  smallest  amount  of  space.  The 
ends  should  now  be  grasped  close  to 
the  tooth  with  a  pair  of  closely-fitting, 
flat-nosed  pliers,  and  the  band  drawn 
tightly  around  the  tooth,  a  strong 
burnisher  being  applied  at  the  same 
time  to  make  it  conform  still  further 
with  the  shape  of  the  tooth.  Re¬ 
move  the  band,  which  now  presents 
the  appearance  shown  in  Fig.  6. 
l^lace  a  small  bit  of  silver  solder 
and  borax  at  the  junction  between  the  ends,  and  carry  the 
band  in  contact  with  the  flame  of  the  soldering  lamp.  After 
it  is  soldered,  clip  the  ends  off,  and  the  band  is  now  ready 
for  any  attachment  which  may  be  made,  after  which  it  is 
cemented  in  position  on  the  tooth,  being  gently  driven  to 
2Jlace  by  means  of  a  foot- shaped  plugger  and  small  mallet. 

If  the  teeth  are  firmlj-  crowded  together,  space  may  be 


Fig.  6. — Plain  Band. 
(Greatly  enlarged.) 


15 


Molar. 

Fig.  7, — Angle’s  Adjustable 
Clamp  Bands. 


gained  for  the  band  by  forcing  first  a 
thin  spatula  between  them. 

Fig.  7  illustrates  the  author’s  new 
adjustable  clamp  bands,  which  he  now 
uses  almost  exclusively  in  banding  the 
molars  and  bicuspids,  as  they  are  much 
quicker  and  easier  to  adjust  and  less  liable  to  loosen  under 
strain. 

In  applying  these  bands,  carefully  work  the  band  over 
the  tooth  to  be  encircled,  being  cautious  not  to  crimp  it,  and 
tighten  the  nut  until  the  band  is  moderately  firm  ;  then  burn¬ 
ish  until  it  fits  accurately  the  surface  of  the  tooth  in  contact 
with  it,  and  mark  the  points  at  which  the  attachments  are  to 
be  made.  Then  loosen  the  nut  and  remove  the  band.  After 
the  attachments  are  made,  carefully  replace  and  firmly  clamp, 
but  do  not  tighten  the  nut  enough  to  strain  the  thread.  Care 
should  also  be  taken  to  avoid  heating  the  screw  or  nut  more 


than  is  necessary. 

It  is  better  to  use  cement  in  attaching  the  band,  although 
it  is  not  absolutely  necessary. 

These  bands  are  adjustable,  and  will  fit  all  teeth  com¬ 
monly  met  with.  For  abnormally  small  teeth,  cut  the  band, 
lap  and  re- solder.  In  this  way  small  bicuspids  and  incisors 
may  be  fitted,  although  the  plain  band  is  usually  preferred  for 
the  incisors.  Jeweler’s  silver  solder  or  18 -karat  gold  solder, 
with  plenty  of  borax,  should  be  used  for  making  the  attach¬ 
ments. 

Fig.  8  illustrates  the  author’s  fracture  bands.* 


They  will  also  be  found  very  useful  in  irregularities,  and 
their  use  explained  later  in  this  edition. 

We  might  illustrate,  without  limit,  the  different  ways  of 


*For  author’s  methods  of  treating  fractures,  see  Haskell’s  Student’s 
Manual  (second  edition),  Garretson’s  Oral  Surgery  (last  edition),  and 
author  on  Irregularities  of  the  Teeth  and  Fractures  of  the  Maxillary 
Bones  (now  in  preparation). 


16 


attaching  and  operating  these  appli* 
ances  in  accomplishing  the  movements 
of  the  teeth,  but  enough  of  the  many 
Fig.  8.— Bicuspid.  Molar.  modifications  of  wlficli  they  are  sus¬ 
ceptible  will  be  shown,  to  enable  the  average  operator  to 
become  sufficiently  familiar  with  them  to  treat  all  cases. 


§  3. — Kotation. 

The  movement  of  rotation  of  a  tooth  is  accomplished  by 
means  of  a  lever  shown  at  “  L,”  Fig.  1.  The  tooth  is  banded 
in  the  manner  already  described.  One  of  the  small  pipes  “  E,” 
Fig.  1,  is  soldered  to  the  labial  surface  of  this  band,  and  the 
band  cemented  in  position  on  the 
tooth ;  one  end  of  the  rotating  lever 
is  inserted  into  the  pine ;  the  other 
end  is  sprung  around  and  latched 
into  a  hook,  soldered  to  a  band,  en¬ 
circling  a  suitable  anchor  tooth. 

Fig.  9  shoAvs  a  lateral  incisor  being 
rotated  by  this  appliance.  It  tvill 
be  seen  that  a  powerful  and  constant 
force  is  beirrg  exerted  upon  the  tooth 
to  be  moved. 

The  anchor  tooth  may  be  reinforced  by  a  piece  of  the 
gold  Avire  G,  Fig.  1,  passing  through  a  pipe  soldered  to  the 
lingual  surface  of  the  band  as  shown,  and  the  ends  of  the  gold 
Avire  resting  upon  the  lingual  surfaces  of  the  first  bicuspid  and 
molar.  The  appliance  is  shoAvn  in  detail  in  Fig.  10.  After 
the  tooth  is  in  proper  position  it  is  retained  by  means  of  a 
short  piece  of  the  gold  Avire,  Avhich  passes  through  the  tube, 
and  extends  upon  the  central,  as  seen  irr  Fig.  11.  This  wire 
is  kept  in  place  by  a  small  pin,  Avhich  is  tightly  fitted  in  a 
very  small  hole,  drilled  through  both  the  tube  and  one  side  of 
the  Avire,  as  shown. 


V 


17 


Fig.  11.— Retainer. 


Fig.  10.— Rotating  Appliance  in  detail. 

Fig.  12  shows  two  powerful  cuspids  while  being  rotated 
by  this  method.  It  will  be  seen  that  the  lever  may  be  applied 
with  an  equal  effect  upon  either  the  inside  or  the  outside  of 
the  arch,  and  in  this  case,  one  anclior  tooth  is  made  to  serve 
for  anchorage  for  both  levers.  It  is  necessarv  to  exercise  both 
care  and  judgment  in  the  use  of  the  powerful  levers. 

First,  the  lever  should  not  be  allowed  to  bind  at  any 

point  upon  the  teeth 
intervening  between, 
the  tooth  being  rotated 
and  the  anchorage, 
lest  the  moving 
tooth  be  pried  out¬ 
ward  ;  second,  care 
should  be  taken 
that  the  movement 
is  not  a  c  c  o  m  - 
plished  more  rap¬ 
idly  than  the  ab¬ 
sorption  of  bone  takes  place,  otherwise  the  tooth  will  be  sprung 
outward,  by  reason  of  the  external  plate  of  the  alveolus,  which, 
being  thinner,  offers  less  resistance,  and  will  be  gradually  bent 
outward. 

§  4.— Double  Eotation. 

When  the  teeth  are  to  be  rotated  in  opposite  directions 

at  the  same  time,  as  the  central  incis¬ 
ors,  shown  in  Fig.  13,  double  rotation 
may  be  accomplished  by  one  lever. 
Both  the  teeth  are  banded,  and 
Fig.  13.  a  tube  soldered  to  each  band;  one 


Fig.  12.— Rotation. 


18 


being  horizontal  and  the  other 
vertical.  A  piece  of  the  lever  “  L” 

Fig.  1  is  bent  at  right  angles  at 
one  end,  and  then  sprung  into 
position,  as  seen  in  Fig.  14.  Fig.  ir.-coubie  Rotation. 

The  tendency  of  the  wire  to  straighten  itself  will  rotate 
both  teeth  at  once.  Eecent  experience  has  shown  that  a  better 
way  of  applying  the  lever  is  to  attach  both  pipes  horizontally, 
■using  a  straight  lever,  springing  and  sliding  it  into  the  last 
pipe  in  the  same  manner  in  which  a  bolt  is  slid  into  position 
in  fastening  a  door,  and  correctly  shown  in  Fig.  23. 

The  piano  wire  used  in  making  this  lever  should  never 
b^hoavier  than  No.  9,  German.  Heavier  will  not  do.  It  may 
be  necessary  to  occasionally  remove  and  straighten  the  lever  a 
little,  in  order  to  maintain  the  pressure.  Should  one  tooth  be 
rotated  sufficiently  before  the  other,  further  movement  may  be 
arrested  by  removing  the  band  and  soldering  a  lug  on  the  lin¬ 
gual  surface,  resting  against  the  lateral  incisors.  And  should 
the  teeth  in  rotating  assume  too  much  prominence,  by  reason 
of  pressure  from  the  adjoining  teeth,  it  may  be  effectually 
^  .obviated  by  requiring  the  patient  to  wear,  for  a  few  nights,  the 
■occipital  bandage  traction  bar,  and  heavy  elastic  band  shov.m 
in  cuts  45  and  46,  filing  a  deep  notch  in  the  end  of  the 
.standard  to  engage  the  rotating  lever.  When  the  teeth  are  in 
position  they  are  retained  by  substituting  a  piece  of  the  non- 
■elastic  gold ^ire,  “G,”  Fig.  1,  for  the  spring  wire,  or  uniting 
the  bands  ®th  solder  and  recementing. 


:  5. — Backward  in  the  Line  of  the  Arch. 

The  backward  movement  of  the  teeth  in  the  line  of  the 
eh  is  Accomplished  by  the  appliance  shown  in  Fig.  15. 
^rst  molar  is  encircled  by  a  clamp  band.  Fig.  7,  and  the 
tube  of  the  heavy  traction  screw  shown  at  “A,”  Fig.  1, 
riglSly  soldered  to  the  band.  The  cuspid  to  be  moved  is 
banded,  and  one  of  the  short  tubes  shown  at  “D,”  Fig.  1, 
is  soldered  to  the  band  to  receive  the  large  traction  screw, 


19 


\ 


‘‘A,”  Fig.  1.  On  turning  the  nut,  traction  is  produced  and  the 
cuspid  pulled  or  tipped  into  place.  Fig.  4  shows  a  side  view 

of  the  same. 

The  screw  may  be 
applied,  either  upon  the 
out  or  inside  of  the  arch, 
and  should  the  cuspid 
also  require  to  be  drawn 
into  the  line  of  the  arch, 
as  well  as  backward,  it 
may  be  accomplished  at 
the  same  time  by  bending 
the  screw  at  the  point 
Fig.  15.— Keiraction  of  Cuspid.  where  it  ciiters  the  long 


pipe*  It  will  gradually  draw  into  the  pipe  as  the  tooth  is 
moved  back,  thereby  accomplishing  both  movements.  And 
should  the  cuspid  also  require  rotating,  as  is  sometimes  neces- 
saryj  it  may  be  accomplished  at  the  same  time  of  retraction,  by 
hooking  the  angle  of  the  traction  screw  over  a  spur  soldered 
at  right  angles  to  the  band,  instead  of  in  the  short  pipe,  thus 
concentrating  all  the  force  in  retraction  to  one  side  of  the 
tooth.  Fig.  38  shows  this  appliance  in  position  upon  the  right 
side. 


The  easiest  way  to  adjust  this  appliance  is  to  first  cement 
the  band  upon  the  cuspid  tooth.  After  the  cement  has  become 
thoroughly  set,  the  angle  of  the  traction  screw  is  hooked  into 
the  pipe,  and  the  other  band  is  now  latched  over  the  molar. 
The  greatest  care  should  be  taken  to  make  this  attachment 
accurate,  using  the  strongest  cement,  as  well  as  a  clamp  band, 
on  the  anchor  tooth.* 

The  nut  should  never  be  tightened  enough,  at  one  time, 
to  strain  the  attachment.  Once  a  day,  just  enough  to  occasion 
a  snug  feeling,  and  never  more. 

After  the  tooth  is  moved  back  it  is  retained  by  the  screw 


*  Two  anchor  bands  are  shown  in  the  engraving,  at  Fig.  4,  but  one  is 
sufficient. 


20 


/ 


already  in  position,  or  tliat  may  be  removed  and  a  piece  of 
gold  wire  substituted. 

The  author  feels  such  a  pride  in  the  appliance,  that  he 
invites  comparison  with  any  other  method  of  performing  the 
difficult  movement  of  retracting  the  cuspid  teeth. 

§  6. — Forward  m  the  Line  of  the  Arch. 

The  movement  of  a  tooth  forward,  in  tlie  line  ol  the 
arch,  is  accomplished  in  the  same  way,  only  selecting  teeth 
from  the  opposite  side,  to  be  used  in  overcoming  the  resistance 
of  the  teeth  which  are  being  moved.  As  in  Fig.  34. 

§  7. — OLn'WARi). 

The  movement  of  a  tooth  from  within,  outward  in  the 

line  of  the  arch, 
is  shown  in  Fis;. 
16,  and  is  accom¬ 
plished  by  the 
jack-screw  “J,” 
Fio’  1 

J-  Ij^.  -L. 

A  firm  an¬ 
chorage  for  the 
resistance  of  the 
screw  is  obtained 
by  banding  and 
tubing  the  left 
cuspid  and  passing  through  the  tube  a  piece  of  gold  wire,  long 
enough  to  extend  to  and  rest  against  the  adjoining  teeth. 
The  opposite  cuspid  to  be  moved  is  banded,  and  a  retaining 
tube  “E,”  Fig.  1,  is  soldered  to  the  labial  surface. 

The  lingual  surface  has  a  slot  cut  in  it,  to  receive  the  flat 
end  of  the  jack-screw ;  the  other  end  of  the  tube  in  which 
the  screw  plays  is  so  notched  with  a  file  that  it  rests  securely 
against  the  reinforcement  wire,  and  the  tube  against  the  lin¬ 
gual  surface  of  the  cuspid  band.  Movement  is  accomplished 


Fig.  16. — Reinforced  Ancliorage 


21 


by  tightening  the  ,nnt.  After  being  brought  into  position  the 

. . ..  tooth  is  retained  by  passing  a  short  piece 

of  the  gold  wire  through  the  retaining  tube 
on  the  labial  surface,  as  shown  in  Fig.  17, 
which  is  held  in  place  until  the  tooth  has 
become  firmly  set  in  its  new  position. 

But  the  author’s  favorite  method  of 


Fig.  17. — Retained. 


reinforcing  the  an¬ 
chorage  where  the 
jack-screw  is  used 
in  forcing  outward 
an  inlocked  tooth, 
is  shown  in  Fig.  18. 

The  anchor 
tooth  is  encircled  by 
a  clamp  band,  hav¬ 
ing  a  spur  one- 
eighth  of  an  inch 


in  length  soldered 

to  it,  over  which  is  slipped  the  base  of  the  sheath  of  the  j  ack- 
screw.  The  chisel  end  of  the  screw  resting  in  a  slot  in  the 
band  encircling  the  moving  tooth  as  in  the  cut  above,  or  filed 
to  a  sharp  point  and  resting  in  a  delicate  pit  formed  in  the 
enamel.  Reinforcement  is  now  gained  by  hooking  a  piece 
of  the  retaining  wire  into  one  of  the  small  pipes  “R,”  Fig.  1, 

previously  soldered  to  the 
upper  side  of  the  sheath 
of  the  jack-screw ;  the 
other  end  is  hooked  into 
one  of  the  little  pipes  sol¬ 
dered  to  the  lingual  sur¬ 
face  of  the  band,  encircling 
the  lateral  incisor.  Thus 
the  most  perfect  anchor¬ 
age  is  secured,  and  by 
doubling  the  reinforce- 

O 


Fig.  19.— Increased  Anchorage. 


22 


ment  wire,  as  in  Fig.  19,  in  which  a  lateral  is  being  moved 
out,  the  moving  tooth  will  provide  space  in  the  arch  for  itself, 
bj  forcing  the  adjoining  teeth  laterally. 

Outward  movement  is  accomplished  bv  another  simple 
method,  shown  on  the  left  of  Fig.  19,  as  follows :  A  strip  of 
band  material  shown  at  “F,”  Fig.  1,  is  looped  about  the  mal- 
posed  tooth,  the  ends  resting  upon  the  labial  surfaces  of  the 
adjoining  teeth. 

To  one  end  of  this  strip  is  soldered  a  tube  “C,”  Fig.  1, 
placed  vertically,  while  to  the  other  end  a  similar  tube  is 
attached  horizontally.  Into  these  tubes  the  small  traction 
screw  “B,”  Fig.  1,  is  placed,  being  bent  to  conform  to  the 
shape  of  the  arch,  and  used  in  this  case  to  push  instead  of  to 
pull.  This  appliance  should  be  frequently  tightened,  by  turn¬ 
ing  the  nut,  or  it  will  become  loose  and  give  trouble. 

The  parts  of  this 
device  are  shown  sepa¬ 
rately  at  Fig.  20.  Fig. 

21  shows  the  teeth  re¬ 
tained  after  the  case 
was  completed. 


Fig.  20. — Device  for 
Outward  Movement. 


Fig  21. — Retained. 


g  8. — Expansion. 

Expansion  of  the  arch  is  accomplished  by  banding  and 
tubino-  the  first  and  last  teeth  of  those  to  be  moved,  on  each 
side,  and  connecting  them  by  means  of  gold  wire  passing 
throu2:h  the  tubes. 

O 

The  jack-screw  is  then  placed  in  position  across  the  arch, 
from  wire  to  wire.  Collars  or  short  tubes  are  soldered  to  the 
wires  at  intervals,  to  keep  the  screw  in  proper  position.  These 
collars  must  be  attached  by  soft  solder,  that  the  temper  of  the 
wire  may  not  be  disturbed.  The  jack-screw  may  be  moved 
forward  or  backward,  according  to  the  varying  requirements 
of  the  case. 


23 


Before  placing  in  position  the  wires  which  pass  along  the 
sides  of  the  arch,  they 
should  be  bent  to  cor¬ 
respond  to  the  shape 
of  the  sides  of  the 
ideal  arch,  or  exactly 
as  we  wish  the  teeth 
to  be  arranged,  after 
the  desired  position  is 
gained.  The  appliances 
in  positions  are  accu¬ 
rately  shoAvn  in  Fig- 
22,  with  the  exception 
that  the  tubes  attached 
to  the  posterior  bands 
should  be  oblique,  as  in  Fig.  23,  instead  of  horizontal. 

Cut  23  shows  a  modification  of  this  method  of  expansion, 

the  power  being  de¬ 
rived  from  one  of  the 
levers,  bent  in  the  form 
of  the  well-known  Cof¬ 
fin  spring,  thus  giving 
us  all  the  advantages- 
of  the  Coffin  method 
of  expansion,  without, 
the  disagreeable  fea¬ 
tures  of  the  rubber 
plate.  Its  chief  ad¬ 
vantage  over  the  above 
method  being,  that  it 
may  be  used  in  expanding  the  lower  arch,  without  interfering 
with  the  movement  of  the  tongue,  as  would  be  were  the  jack- 
screws  used. 

The  appliance  for  double  rotation  shown  upon  the  central 
incisors  in  this  enmavins:  has  already  been  described,  and  is 

O  O  ' 


Fig  22. 


24 


only  shown  to  illustrate  liow  it  may  be  used  with  advantage 
in  some  cases,  while  the  arch  is  being  expanded  laterally. 

A  rubber  ligature  is  seen  connecting  the  expansion  spring 
with  the  rotating  lever,  for  the  purpose  of  reducing  prominence 
of  the  incisors  during  rotation.  The  extra  tubes,  soldered  at 
right  angles  to  little  collars,  slipped  upon  the  bars  on  each  side 
of  the  arch,  are  for  the  purpose  of  engaging  the  ends  of  the 
expanding  spring,  should  it  be  found  necessary  to  transfer  the 
pressure  to  this  part  of  the  arch. 

A  valuable  way  of  moving  a  tooth  farther  than  this  side- 
bar,  should  it  be  found  necessary  (for  the  purpose  of  better 
occlusion),  is  to  stretch  a  rubber  wedge  between  the  tooth  and 
the  bar,  as  shown  in  Fig.  49.  This  simple  method  of  moving 
a  tooth  a  little  farther  than  the  appliance  designed  for  the  oc¬ 
casion  will  accomplish,  will  be  found  yery  valuable  in  connec¬ 
tion  with  other  parts  of  this  system. 


9. — Inwakd. 


The  movement  from  without  inward,  into  the  line  of  the 
arch,  msij  be  accomplished  as  shown  in  Fig.  24. 

The  cuspid  tooth  is  banded,  and'  a  piece  of  the  gold  wire, 
bent  sharply  at  right 


angles,  hooked  into 
a  pipe,  soldered  to 
the  surface.  The 
other  end  of  the 
wire  is  soldered  to  a 
pipe,  through  Avhich 
the  small  traction 
screw  is  slipped,  and 
against  which  the 
nut  works. 


Fig  24.— Inward. 


The  other  end  of  the  traction  screw  is  hooked  into  a 
pipe,  soldered  to  a  band,  encircling  the  first  molar.  The  an¬ 
chorage  of  this  tooth  is  further  reinforced  by  a  piece  of  the 


/ 


25 


gold  wire,  which  is  slipped  through  a  tube,  soldered  to  the 
buccal  surface  of  this  band,  the  end  of  the  wire  resting  against 
the  adjoining  teeth.  Eetention  is  accomplished  in  a  manner 
similar  to  that  shown  in  Fig.  17. 

If  the  tongue  becomes  abraded  by  the  end  of  the  screw, 
as  it  emerges  from  the  nut,  a  very  nice  way  of  protecting  it. 
as  in  all  similar  cases,  is  for  the  patient  to  lay  over  the  end  of 
the  screw  a  very  small  piece  of  the  very  common  article 
known  as  chewing  gum. 

§  10. — Elongation  oe  Foecible  Eeuption. 

The  partial  or  complete  failure  of  a  tooth  to  erupt,  fre¬ 
quently  necessitates  the  employment  of  a  corrective  appliance. 
In  dental  literature,  a  number  of  appliances  are  put  on  record 
as  accomplishing  the  forcible  protrusion  of  teeth,  the  power 
being  derived  from  screws,  springs  or  ligatures.  All  these 
devices  are  similar  in  that  they  are  anchored  by  means  of 
plates,  “cribs”  or  clasps,  attached  to  the  same  arch  which 
contains  the  malposed  teeth.  While  the  appliance  here 
shown  derives  its  anchorage  by  being  attached  to  teeth  in  the 
opposite  jaw,  all  plates,  “cribs,”  springs,  etc.,  being  discarded, 
thereby  rendering  the  appliance  simpler,  more  compact  and 
cleanly,  besides  making  it  far  more  agreeable  for  the  patient, 
without  in  any  degree  lessening  its  efficiency. 

Fig.  25  shows  the  principle  of  this  device,  as  applied  in 

the  treatiuent  of  a  very 
common  form  of  irregu¬ 
larity,  in  which  the  tem¬ 
porary  cuspid  lias  been 
retained  too  long,  causing 
the  permanent  cuspid  to 
erupt  forward,  and  above 
its  proper  place.  In  this 
instance,  the  temporary  cuspid  was  extracted,  and  the  loAver 


26 


\ 


second  bicuspid  was  encircled  by  one  of  tbe  author’s  fracture - 
bands,  Fig.  8. 

A  very  small  hole  was  drilled  into  the  cuspid,  and  a  short 
pin  was  set  with  thin  cement.  A  common  pin  answers  the 
purpose  very  well,  and  the  hole  need  not  be  any  deeper  than 
the  enamel,  if  the  pin  is  accurately  fitted  to  it.  A  rubber 
ligature’ was  given  the  patient,  with  instructions  to  slip  it  over 
the  pins,  as  shown  in  the  engraving  Fig.  25.  The  ligature 
tends  to  keep  the  teeth  in  occlusion.  The  anchor  tooth  is 
directly  opposed  by  the  superior  bicuspid,  and  supported  by 
the  inferior  first  molar  and  first  bicuspid.  It  will  thus  be  seen 
that  this  anchorage  is  the  simplest  and  most  efficient  possible 
to  obtain. 

The  ligature  may  be  worn  at  nighttime  only,  so  as  to 
interfere  with  speech  and  mastication  as  little  as  possible, 
although  some  patients  wear  it  more  or  less  continuously. 

A  too  strong  ligature  should  not  be  worn,  as  it  might 
endanger  the  life  of  the  pulp ;  but  gentle  traction  should  be 
used,  gradually  directing  the  tooth  downward  into  its  proper 
position. 

This  simple  appliance  will  be  worn  without  complaint  by 
the  patient,  as  long  as  it  shall  be  found  necessary. 

I  prefer  cutting  the  ligature  from  heavy  rubber- dam,  as 
suggested  by  Dr.  Black  several  years  ago,  or  from  thin  rubber 
bands,  such  as  are  used  for  holding  packages  of  paper  together.. 
First  punching  a  hole  with  the  largest  size  of  the  rubber- dam 
punch,  and  afterward  cutting  the  outside  down  to  the  desired 
strength  with  scissors. 

The  direction  of  the  force  to  be  exerted  upon  the  tooth 
to  be  moved  will,  of  course,  indicate  which  tooth  in  the  infe¬ 
rior  arch  should  be  selected  for  anchorage.  Should  the  an¬ 
chorage  fall  upon  a  tooth  with  no  antagonist,  there  would,  of 
course,  be  danger  of  loosening  it. 

Fig.  26  shows  such  a  case  in  which  the  anchorage  was. 
modified  to  suit  the  condition  found. 


27 


The  case  was  that  of  a 
young  lady,  seventeen  years 
of  age.  The  deciduous  cus¬ 
pid  had  been  retained  too 
long,  causing  the  permanent 
cuspid  to  become  imbedded 


in  the  alveolar  process  on  the  "  ^ 

lingual  side  of  the  lateral  in-  ^ 

cisor,  thus  necessitating  complex  movements  of  the  tooth — 
backward,  outward,  downward — requiring  a  very  firm  anchor¬ 
age,  which  was  gained  by  encircling  the  inferior  cuspid  and 
second  bicuspid  with  bands,  having  delicate  tubes  attached  to 
their  labial  surfaces.  A  piece  of  the  gold  wdre  (Fig.  1,  G-)  of 
the  proper  length  was  provided,  the  ends  of  which  were  bent 
at  right  angles  and  slipped  through  the  tubes  upon  the  anchor 
teeth,  as  shown  in  the  engraving.  Fig.  26. 

The  wire  fits  the  bores  of  the  tubes  so  accurately,  that  in 
cutting  off  the  ends  which  emerge  through  them,  each  end 
spreads  sufficiently  to  prevent  its  coming  out.  A  |)in  was 
soldered  to  the  wire  about  midway  between  the  pipes  and  one 
cemented  in  the  cuspid  cusp,  as  in  the  case  first  described. 

When  the  ligature  was  stretched  from  pin  to  pin,  as  seen 
in  the  engraving,  the  anchor  teeth — two  in  each  jaw — were 
thus  made  to  oppose  the  cuspid  to  be  moved. 


Fig.  27  shows  another 
modification  of  the  latter 
method  of  anchorage. 


The  anchor  wire  was 
made  detachable,  and  the 
pin  dispensed  with,  the 
patient  slipping  the  wire 
through  the  ligature  and 
into  the  pipes  upon  retir¬ 


Fig.  27, 


ing,  and  removing  it  during  the  day,  as  the  ends  of  the  wire 
had  not  been  spread.  A  delicate  band,  bearing  a  pin  upon  its 
labial  surface,  was  cemented  to  the  tooth  to  be  moved. 


28 


Anotlier  very  useful  purpose  for  whicli  these  anchor- wire 
bands  and  pipes  may  be  used,  as  shown  in  this  engraving,  is  a 
splint  for  supporting  teeth  that  have  been  loosened  by  salivary 
calculus,  or  have  been  transplanted,  replanted,  or  implanted. 
The  teeth  to  be  fastened  should  be  bound  or  ligated  to  the 
splint. 

Fig.  28  shows  a  case  in  which  the  appliance  used  was 
very  similar  to  those  before  described,  but  this  anchorage  was 

attached  to  the  teeth  in 
the  same  arch  in  which 
was  located  the  malposed 
tooth. 

The  appliance  in  de¬ 
tail  is  as  follows :  The 
first  bicuspid  was  banded 
and  a  pipe  soldered  to  the 
labial  surface  of  the  band, 
in  which  was  hooked  the 
piece  of  the  gold  wire,  the  other  end  being  bent,  so  as  to  rest 
on  the  cutting  edge  of  the  lateral  incisor.  A  pin  was  soldered 
to  this  wire,  as  in  the  case  before  described,  and  a  delicate 
ligature  was  then  stretched  from  pin  to  pin,  thus  exerting  a 
gentle  but  constant  traction.  With  this  appliance,  the  ligature 
is  worn  continuously.  In  some  case^,  where  more  force  was 
necessary,  I  used  advantageously  the  combined  anchorage 
herein  described.  The  delicate  ligatures  shown  in  the  appliance 
last  described,  were  used  in  the  daytime,  to  assist  the  action 
of  and  constantly  retain  what  had  been  gained  by  the  more 
powerful  anchorage  on  the  lower  teeth,  acting  during  the 
night. 

We  have  now  completed  the  description  of  the  principal 
ways  of  adjusting  the  appliances  for  performing  the  simple 
movements  of  the  teeth,  and  in  treating  practical  cases  of  ir¬ 
regularities,  no  matter  how  complicated  or  simple,  the  same 
principles  would  be  repeated  (singly  or  in  combinations),  and 
we  herewith  append  a  few  jiractical  cases,  in  order  to  still 


29 


further  familiarize  the  reader  with  this  system,  and  thus  enable 
him  to  more  easily  comprehend  its  intelligent  employment. 

Fig.  29  represents  a  case  of  irregidarities,  as  a  result  of  a 
contracted  condition  of  the  lips,  thus  bringing  undue  pressure 
on  the  anterior  part  of 
the  arch,  at  the  time 
when  the  teeth  were 
taking  their  positions, 
and  forcing  them  in¬ 
ward  as  represented. 

were  forced 
outward  by  the  jack- 
screws  resting  over 
spurs,  in  bands  en¬ 
circling  the  anchor 
teetli ;  the  chisel  ends  of  the  screw  resting  in  slots,  in  bands 
encircling  the  moving  teeth,  exactly  as  before  described  in  the 
use  of  the  screw,  and  now  so  well  shown  in  the  eno’ravin^. 

7  O  O 

The  teeth  were  also  rotated  at  tlie  same  time  with  rotating 
levers,  in  a  manner  already  desciibed  in  the  description  of  the 
use  of  the  rotating  levers,  and  also  well  shown  in  this  en¬ 
graving.  It  will  be  seen  that  two  rotating  levers  were  used, 
crossing  each  other  in  the  centre,  the  one  on  the  left  being 
anchored  by  latching  it  into  a  hook,  soldered  to  the  anchor 
band  on  the  second  bicuspid ;  the  other  lever  being  anchored 
by  hooking  the  same  into  one  of  the  little  jolpes,  soldered  at 
right  angles  to  the  pipe  on  the  lateral  which  engages  the  other 
lever. 

A  better  way  would  have  been,  to  have  simply  tied  this 
end  of  the  lever  to  the  other,  but  it  is  here  shown  to  illustrate 
one  of  the  many  ways  which  circumstances  may  indicate  for 
’securing  the  end  of  the  lever. 

It  will  be  seen  that  the  central  incisor  also  needs  rotating ; 
this  could,  of  course,  have  been  easily  accomplished  by  the 
lever  in  double  rotation,  already  described,  but  best  shown  in 
Fig.  28.  But  the  same  practical  result  was  accomplished  by 


30 


firmly  lacing  tliem  to  the  levers  passing  in  front.  After  they 
moved  into  the  desired  position,  they  were  retained  by  uniting 


with  solder  bands,  en¬ 
circling  all  four  of  the 
incisors,  as  shown  in 
cut.  Fig.  30,  which  is 
a  very  excellent 
method  of  retention, 
and  was  first  suggested 
by  Dr.  Guilford,  I 
believe.  They,  of 
course,  could  have 
been  retained  by  my 


Fig.  30. 


own  method,  namely :  passing  a  piece  of  retaining  wire  from 
tube  to  tube,  and  lacing  the  central  to  it.  But  although  very 
simple  and  effectual,  it  would  have  been  more  unsightly. 

Cut,  Fig.  31,  shows  another  case  from  the  author’s  prac¬ 
tice,  and  one  quite  frequently  encountered,  in  some  of  its 


modifications. 

The  cuspid  has 


taken  an  inlocked 
position,  and  has 
forced  the  lateral 
outward.  It  will  be 
seen  by  studying  the 
appliance,  that  it 
served  the  double 


purpose  of  forcing  '  ^  ^  ' 

outward  the  cuspid, 

and  at  the  same  time  drawing  inward  the  lateral,  by  reason 
of  the  sheath  of  the  jack-screw  being  cut  shorter,  thus  allow¬ 
ing  it  to  travel  downward  over  the  spur  supporting  its  base, 
as  the  nut  is  tightened  until  its  base  finally  rests  against  the 
band,  when  the  lateral  will  have  been  drawn  into  place,  and 
will  still  further  assist  the  anchor  teeth  in  resistino^  the  moving^ 

O  O 

cuspids. 


31 


This  is  what  is  known  as  reciprocal  anchorage,  or  that 
-  of  pitting  one  irregular  tooth  against  another,  and  is  a  prin¬ 
ciple  of  great  value,  and  should  be  carefully  studied  and  made- 
use  of  whenever  possible. 

The  extra  pipe  shown  upon  the  sheath  of  the  jack -sere av 
was  placed  there  in  anticipation  of  further  reinforcing  the 
anchorage,  should  it  become  necessary,  by  hooking  another 
piece  of  gold  wire  into  the  same  ;  the  other  end  being  hooked 
into  similar  pipes  on  adjoining  bicuspid. 

Reciprocal  power  may,  in  some  cases,  be  gained  with  ad¬ 
vantage  by  substituting  the  gold  Avire  attached  to  the  lateral, 
Avith  the  small  traction  screw,  letters  C  and  B,  of  Eig.  1. 

After  these  teeth 
were  correctly  adjusted, 
they  were  retained  by 
uniting  the  bands  Avitli 
.  solder  and  recementing 
upon  the  teeth. 

Fig.  32  s  h  o  yr  s 
another  case  quite  fre¬ 
quently  met  with ;  also, 
the  combination  of  the 
.  appliances  which  were 
used  in  their  treatment. 

The  lateral  incisors  Avere  inlocked,  the  left  cuspid  pushed 
forAvard,  necessitating  retraction,  and  the  movement  of  from 
in  outwards,  of  the  tAvo  inlocked  laterals.  It  Avill  be  seen 
that  Avhile  the  large  traction  screw  is  drawing  back  the  promi¬ 
nent  cuspid,  it  is  assisted  by  the  loop  and  small  traction  screw. 
Fig.  19 ;  acting  at  the  same  time  in  forcing  outAvard  the  left 
lateral,  thus  gaining  the  benefit  of  reciprocal  anchorage. 

It  will  also  be  noticed  that  the  other  lateral  is  being- 
forced  outAvard  by  the  jack-scrcAV,  the  base  of  Avhich  is  slipped 
•  over  a  spur,  soldered  to  the  sheath  of  the  large  traction  sctcav, 
.-again  making  use  of  reciprocal  anchorage  hy  assisting  the 
large  traction  screAV  in  resisting  the  force  of  the  cuspid.  Of 


32 


course  the  anchorage  of  the  jack-screw  might  be  reinforced^ 
as  already  described  in  Fig.  18.  Other  modifications  of  this 
combination  will  readily  suggest  themselves. 

Cut,  Fig.  33, 
represents  another 
very  common  form 
of  irregularity, 
which  often  is  a  re¬ 
sult  *of  the  habit  of 
contracting  the  lips. 

All  of  the  in¬ 
cisors  are 
inward,  not  necessa¬ 
rily  enough  to  cause 
inlocking  of  the  same,  but  enough  to  necessitate  the 
closure  of  the  loAver  jaw,  posterior  to  the  normal  occlusion, 
in  some  instances  causing  jumping  of  the  bite.  As  a  result, 
there  is  not  sufficient  room  for  the  cuspids  to  take  their 
natural  positions,  but  in  attempting  to  do  so  (a  tendency 
always  very  strong  with  them),  the  laterals  are  forced  still 
farther  inward,  as  well  as  partially  rotated.  The  proper  treat¬ 
ment  is,  therefore,  to 
force  forward  all  the 
incisors  to  their  cor- 


making  possible  cor¬ 
rect  occlusion,  as  well 
as  providing  space  for 
the  cuspids.  It  will 
be  seen  that  the  rota¬ 
ting  levers  are  applied 
to  the  laterals,  and  the 
centrals  firmly  laced  to  the  same,  while  all  are  being  forced 
forward  by  the  jack-screws,  soldered  to  the  anchor  bands, 
the  chisel  ends  resting  against  small  half-circular  pieces  of 
wire,  soldered  to  the  bands  on  the  lateral,  which  permitted 


rect  position,  thereb}^ 


Fig.  33. 


33 


tbeir  rotation.  The  cuspids  were  brought  downward  by  the 
methods  shown  in  Fis:.  25. 

Fig.  34  shows  a  cuspid  tooth  being  moved  outward. 

The  base  of  the  jack-screw  is  soldered  to  a  band  encir¬ 
cling  the  opposite  cuspid,  and  reinforced  by  a  spur,  resting 

against  the  first  bicus¬ 
pid,  and  also  by  the 
large  traction  screw 
which  is  hooked  into 
a  pipe,  soldered  to  the 
labial  surface  of  the 
band,  and  passing  in 
front  of  the  incisors 
through  a  tube, 
against  whicli  the  nut 
Fig.  35,— Case  as  Completed.  WOrks,  Soldcrcd  to  a 

band  on  the  labial  surface  of  the  lateral  incisor. 

In  this  case,  the 
left  central  and  lateral 
were  moved  forward 
in  the  line  of  arch, 
thereby  closing  the 
space  between  the  cen¬ 
trals,  and,  at  the  same 
time,  providing  space 
for  the  out-moving 
cuspid.  The  large 
screw  was  beaten  flat 
and  polished  before  in- 
ertions. 

Fig.  35  shows  the  same  case  after  completion. 

Fig.  36  shows  another  case  of  very  marked  irregularity, 
where  both  centrals  and  laterals  and  right  cuspid  are  greatly 
turned  from  their  natural  positions.  They  are  also  pushed 
forward,  as  well  shown  in  Fig.  37,  which  represents  a  side 
view  of  the  case. 


Fig.  36. 


34 


Fig.  38  sliows  tlie 
appliances  as  adjusted  at 
the  commencement  of  the 
treatment.  It  will  be  seen 
that  the  cuspids  are  being 
retracted,  by  means  of  the 
large  traction  screws,  into 
the  spaces  from  which  the 
first  bicuspids  have  been 
extracted.  It  will  also  be  noticed  that  the  angle  of  the  traction 
screw  on  the  right  is  hooked  over  a  spur  (soldered  at  right 
angles  to  the  band,  in¬ 
stead  of  being  hooked 
into  the  short  pipe,  as 
on  the  other  side),  for 
the  purpose  of  rotat¬ 
ing  the  cuspid  as  it 
moved  backward,  and 
described  in  Fig.  15. 

The  central  incis¬ 
ors  are  being  rotated 
by  means  of  the  lever, 
as  described  in  Fig.  23. 

Their  prominence  was  also  reduced  at  the  same  time,  by  means 
of  the  occipital  bandage  and  traction  bar,  as  described  on  page  40. 

Fig.  39  shows  the  ease 
after  being  acted  upon  by  the 
appliances  already  described. 
They  were  retained  in 
this  position  by  uniting 
with  solder  the  bands 
on  the  centrals  together, 
and  recernenting  upon 
the  teeth,  while  the 
traction  screws  retained 
the  cuspids. 


35 


The  next  stage  in  the  operation  was  the  rotation  of  the 
lateral  incisors,  which  was 
accomplished  by  the  rotating 
levers  in  the  usual  way,  and 
described  on  page  14. 

After  they  were  rotated, 
the  bands  were  removed  and 
united  with  solder  to  the 
bands  npon  the  centrals,  and 


reset  on  the  teeth  with 
cement.  The  traction  screws 
and  bands  upon  the  cuspids 
were  removed,  and  the  case 
then  presented  the  appear¬ 
ance  as  shown  in  Figs.  40 
Fig.  41.  and  41. 

The  retaining  bands  upon  the  incisors  were  worn  one 
year,  alter  which  the  teeth  showed  no  tendency  to  return  to 
their  former  position. 


CHAPTER  II. 


§  11. — Angle’s  Regulating  and  Retaining  Appliances. 

Set  Ho.  2. 

Probably  no  appliance  yet  devised  for  the  treatment  of 
dental  irregularities,  will  admit  of  such  universal  application 

as  this  appliance ; 
and,  at  the  same 
time,  inconveni¬ 
ence  the  patient 
so  little,  and 
prove  so  satisfac¬ 
tory  to  the  opera¬ 
tor;  especially  in 
those  cases  that 
are  best  adapted 

Fig.  42. — Set  No.  2,  Angle’s  Appliances.  USe,  and 

which  will  be  indicated  later  on. 

For  with  it,  we  can  move  out  teeth  that  are  inlocked, 
force  into  line  outstanding  teeth,  perform  the  movement  of 
rotation,  expand  the  arch  anteriorly,  or  one  or  both  sides  of 
the  arch,  compress  teeth  in  their  sockets,  or  elongate  or  force 
their  eruption,  and  it  is  also  equally  applicable  to  both  arches. 

And  with  it,  we  can  easilv  treat  those  common,  and 
usually  regarded 
difficult  cases, 
known  as  excessive 
protrusion  of  the 
incisors  and  cus¬ 
pids^  and  repre¬ 
sented  in  Fig.  43. 

It  was  for  this 
elass  of  cases  the  Excessive  Protrusion. 

appliance  was  originally  devised. 

36 


37 


W e  will,  therefore,  first  describe  its  use  in  their  treatment. 

The  anchor  clamp  band  D,  Fig.  42,  is  slipped  over  the 
anchor  teeth,  usually  the  first  molars,  and  adjusted  so  that  the 
pipes  on  the  buccal  sides  of  the  teeth  will  carefully  line  with 
the  arch. 

,  The  nuts  are  now  tightened,  and  the  band  carefully  burn¬ 
ished,  until  they  fit  accurately  the  teeth  they  encircle.  The 
wire  arch,  Fig.  42,  is  carefully  bent,  to  conform  to  the  shape 
of  the  dental  arch,  provided  the  dental  arch  is  correct  in  form ; 
but  if  it  is  contracted,  or  the  teeth  occupy  irregular  positions, 
no  attention  is  paid  to  the  form  of  the  existing  arch,  but  an 
ideal  arch  is  formed  for  the  case.  Or,  in  other  words,  the 


Fig.  44. 


wire  arch  is  bent  exactly  to  the  form  that  we  wish  the  teeth 
to  be  arranged  when  the  operation  is  completed.  The  ends 
of  the  ideal  arch  are  now  slipped  through  the  pipes  on  the 
molars.  The  anterior  part  of  the  arch  is  kept  from  sliding  up 
and  impinging  upon  the  gums,  by  resting  in  suitable  niches, 
formed  in  the  delicate  bands.  Fig.  42,  encircling  and  cemented  to 
the  centrals  or  lateral  incisors.  It  is  shown  in  position  upon 
the  teeth  in  Fig.  44. 

The  power  to  be  exerted  in  moving  backward  these  teeth 
is  derived  from  heavy  elastic  bands,  attached  to  a  cap,  cover- 


38 


ing  the  back  part  of  the  head,  as  in  Fig.  46,  thus  gaining  ^ 
occipital  anchorage,  instead  of  depending  upon  the  anchorage 
of  the  molar  teeth,  which  is  never  enough  in  these  cases  to 
withstand  the  great  strain  necessary  to  force  backward  the 
protruding  teeth,  but  are  always,  when  so  relied  upon,  tipped 
forward  more  or  less,  and  faulty  occlusion  established.  The 
occipital  anchorage  prevents  this  annoyance. 

Fig.  45  represents  a  traction  bar,  used  for  conveying  the 
force  from  the  occipital  bandage  and  distributing  it  to  the  wire 
arch. 


A  spur  or  standard  will  be  seen  in  the  centre  of  this  bar, 
provided  with  a  socket  in  the  end,  which,  when  in  position, 
engages  a  small  ball,  soldered  to  a  delicate  tube,  encircling  the 
center  of  the  wire  arch,  as  is  shown  in  Fig.  44. 

If  the  reader  is  familiar  with  the  appliance,  so  far  described, 
it  will  be  seen  that  the  force  received  from  the  occipital  band¬ 
age  is  distributed  to  the  wire  arch,  through  the  ball  and  socket 
joint. 

The  ends  of  the  traction  bar  may,  therefore,  be  moved  in 
any  direction,  without  interfering  with  the  pressure  from  the 
bandage.  The  advantage  of  this  attachment  is  that,  in  con¬ 
sequence  of  the  freedom  of  motion,  any  jar  or  shock  upon  the 
traction  bar  will  not  be  transmitted  to  the  tender  teeth.  As 
the  bandage  and  bar  are  to  be  worn  only  at  night,  shocks  from 
contact  with  the  pillow  would  be  very  liable  to  occur  and  oc¬ 
casion  pain,  were  it  not  that  the  bar  is  provided  with  this 
freedom  of  movement.  This  is  a  point  of  advantage  which, 
I  think,  all  will  appreciate,  and  one  possessed  by  no  other 
device.  The  usual  method  is  to  attach  the  traction  bar,  or  its 
equivalent,  to  a  swaged  or  vulcauite  cap  covering,  and  firmly 
resting  against  all  the  teeth  to  be  moved. 


39 


As  the  heavy  rubber  ligatures  of  the  bandage  act  during 
the  night  only,  provision  must  be  made  to  hold  through  the 
day  what  is  gained  at  night.  This  is  effectually  accomplished 
by  delicate  rubber  ligatures,  which  are  slipped  over  the  distal 
ends  of  the  pipes  on  the  molars,  stretched  forward,  and  tied 
with  silk  lis^atures  in  front  of  the  small  collars  which  encircle 
the  wire  arch,  opposite  the  cuspids,  as  seen  in  Fig.  44.  These 
collars  being  rigid,  prevent  the  ligatures  from  sliding  back, 
thus  exerting  a  gentle  but  constant  traction  on  the  moving 
teeth,  and  prevent  them  from  springing  back  and  interfering 
with  the  healing  process  of  repair. 

Another  advantage  of  the  device  is,  that  not  only  the 
prominence  of  the  teeth  is  reduced,  but  teeth  that  are  irregu¬ 
lar  are  gradually  forced  to  take  regular  positions,  and  conform 
to  the  shape  of  the  ideal  arch  (as  it  is  forced  backward  through 
the  pipes  on  the  molars),  something  impossible  with  devices 
having  fixed  caps  of  vulcanite  or  gold. 

Still  another  advantage  is,  that  if  the  arch  needs  expand¬ 
ing,  as  is  frequently  the  case,  it  may  be  easily  accomplished 

at  the  same  time  the 
teeth  are  being 
moved  backward, 
by  lacing  to  the  wire 
arch  such  teeth  as 
need  to  be  moved 
outward. 

For  the  band¬ 
age  proper,  as  a 
result  of  much 
experimenting,  I 
believe  that  shown 
in  Fig.  46  to  be 
much  superior  to 
any  other. 

It  consists  of  a 
stiff,  round,  wire 


40 


band,  large  enough  to  encircle  the  head,  and  having  coarse  black 
silk  net  (as  shown  in  the  engTaving)  sewn  over  it.  This  netting  is 
known  as  black  silk  fish -net,  and  is  used  by  ladies  for  draping 
dresses,  and  may  be  procured  at  any  dry  goods  store  at  a  very 
small  expense.  The  great  advantage  of  this  style  of  band  is 
that  the  pressure  is  equally  distributed  over  all  parts  of  the 
bandage,  thus  admitting  of  much  pressure  from  the  bands 
without  inconvenience. 

The  elastic  bands  seen  in  the  engraving  are  those  com¬ 
monly  used  in  holding  packages  of  paper  together.  They 
may  be  procured  at  any  stationer’s,  or  will  be  furnished  when 
desired.  They  are  about  three  and  one-half  inches  in  length 
and  three-eighths  inches  in  width.  One  end  is  passed  through 
one  of  the  meshes  of  the  net  and  looped  around  the  wire,  and 
carried  down  and  hooked  over  the  end  of  the  traction  bar, 
all  so  well  shown  in  the  cut  that  it  will  be  readily  understood. 
These  ligatures  may  be  doubled  after  the  patient  has  become 
well  accustomed  to  wearing  them. 


Fig.  47  shows  a  common  silk  traveling  cap,  which  may 

be  used  and  is  preferred 
by  some,  although  we 
prefer  the  former. 

For  this  style  of 
bandage  two  ligatures 
should  be  attached  to  the 
cap  on  each  side,  one 
above  and  one  below  the 
ear,  as  shown  in  Fig.  46. 
If  the  bands  be  of  equal 
width,  the  force  will  be 
exerted  in  the  direction  of 
the  meatus  of  the  ear. 
This  is  the  point  to  which, 
in  most  cases,  the  force 
should  be  directed.  In 
Fig.  47. — Occipital  Anchorage.  many  cases,  however,  the 


/ 


41 


teeth  should' be  compressed  in  their  sockets,  as  well  as  drawn 
backward.  This  is  easily  accomplished  by  doubling  the 
strength  of  the  upper,  and  attaching  it  at  a  point  on  the  cap 
as  far  forward  as  desired. 

Again,  if  elongation  of  the  teeth  be  necessary,  as  they 
are  moved  backward,  the  lower  ligature  only  is  used,  dis¬ 
pensing  with  the  upper,  or  using  a  very  light  one. 

After  the  teeth  have  been  moved  into  the  desired  position, 
they  are  effectually  retained  by  the  wire  arch  (the  head  gear, 
traction  bar,  and  delicate  ligatures,  are,  of  course,  dispensed 
with),  and  keeping  the  same  by  passing  a  delicate  drill  through 
the  pipes  on  the  anchor  teeth,  and  inserting  neatly  fitting  pins 
into  the  holes  thus  made,  same  as  in  Fig.  17. 

This  method  of  retaining  is  very  effectual,  and,  as  long  as 
the  appliance  is  so  worn,  the  teeth  cannot  change  their  proper 
positions. 

But  it  has  the  serious  objection  of  being  unsightly,  and,  as 
it  has  been  already  worn  some  considerable  time,  the  patient 
will  usually  become  tired  of  wearing  it,  and  ask  for  its  re¬ 
moval.  And  as  it  is  of  the  greatest  importance  in  these  cases 
that  the  teeth  be  firmly  retained  for  a  long  period  (at  least  one 
year),  it  becomes  necessary  that  we  resort  to  some  other  de¬ 
vice,  less  objectionable  to  appearances. 

After  much  experimenting,  I  find  the  appliance  shown 
in  Fig.  48  quite  effectually  meets  all  requirements.  It  is  re¬ 
tention  by  means  of  the  occipital  bandage,  but  should  never 
be  applied  as  soon  as  the  movement  of  the  teeth  have  been 
completed,  but  only  after  the  other  appliance  has  been  worn 
at  least  two  months,  or  long  enough  to  allow  the  teeth  to  have 
become  thoroughly  rested  in  their  new  positions,  and  firmness 
somewhat  established. 

The  arch,  bands  and  pipes  upon  the  molar  teeth,  as  well 
as  bands  encircling  the  incisors,  are  now  all  removed  and  the 
teeth  thoroughly  cleansed.  After  which,  careful  impressions 
are  taken  of  both  upper  and  lower  jaws,  from  which  accurate 
models  are  made.  Careful  comparison  is  to  be  made,  from 


42 


time  to  time,  with  the .  natural  teeth  and  these  models,  in 
order  to  detect  any  unfavorable  changes,  should  thej^  occur. 

The  next  retaining  appliance  is  now  adjusted,  and  is  to 
be  worn  at  nighttime  only,  thus  allowing  the  patient  entire 
freedom  from  all  appliances  during  the  day.  It  consists  of  a 
piece  of  German  silver  or  gold  wire,  long  enough  to  pass  in 
front  of  the  incisors  and  cuspids,  and  carefully  bent,  so  that  it 
will  rest  in  contact  with  them.  Two  short  pieces  of  gold 
wire,  from  Set  No.  1,  are  soldered  at  right  angles  to  this  wire, 
opposite  the  front  of  the  central  incisors.  They  are  long 
enough  to  admit  the  ends  being  bent  over  the  cutting  edges 
of  the  incisors,  and  the  hooks  so  formed  will  prevent  the  ap¬ 
pliance  sliding  upward  against  the  gum.  The  device  is  pre¬ 
vented  from  sliding  laterally  by  a  short  piece  of  j^he  wire 
being  placed  across  the  heavy  wire  at  a  point  between  the  in¬ 
cisors  where  it  is  soldered.  This  spur  should  rest  in  the 
depression  between  these  teeth ;  the  other  end  passes  slightly 
beyond  the  wire  arch,  where  it  is  to  engage  the  socket  of  the 
standard  of  the  traction  bar. 

All  accurately  shown  in  the  engraving.  It  is  adjusted  by 
slipping  it  into  position  upon  the  teeth,  and,  if  it  has  been 

carefully  made,  will  not  be  dis¬ 
placed  after  the  head  gear  and 
traction  bar  have  been  adjusted. 
The  elastic  bands  in  the  head 
gear  must  be  quite  delicate,  ex¬ 
erting  only  sufficient  pressure  to 
prevent  the  teeth  from  moving 
forward,  which  must  be  carefully  watched  until  the  proper 
tension  is  gained. 

The  above  appliance  must  be  worn  every  night  for  three 
or  four  months,  after  which  every  alternate  night  will  usually 
be  found  sufficient ;  and  finally  it  may  be  worn  one  or  two 
nights  in  the  week  only,  or  as  the  judgment  of  the  operator 
will  determine.  But  it  must  be  insisted  upon  that  it  shall  be 
worn  regularly.  If  it  is  found  that  the  patient  will  not  ob- 


Fig.  48. 


43 


serve  system  in  wearing  this  appliance,  the  former  method  of 
retention  should  be  again  resorted  to. 

So  much  for  the  use  of  No.  2  appliance  in  the  first  class  of 
cases,  i.  e.^  excessive  protrusion. 

We  now  come  to  consider  the  use  of  the  No.  2  appliance- 
in  mixed  cases  of  irregularities. 

Fig.  49  represents  another  class  of  irregularities  directly 

opposite  that 
shown  in  Fig.  43, 
for  in  this  class 
we  have  protru¬ 
sion  of  the  lower 
front  teeth,  al¬ 
ways  accompa¬ 
nied  more  or  less 
Fig.  49.  with  prominence 

of  the  inferior  maxilla,  and  a  lack  of  sufficient  prominence  of 
the  upper  front  teeth.  In  this  class  are  ofttimes  found  our 
most  difficult  cases,  but  when  taken  at  the  proper  age,  and 
the  prominence  be  not  too  excessive,  they  may  be  quite  easily 
treated,  and  the  facial  appearance  of  the  patient  show  greater 
improvement  than  in  any  other  class  of  cases. 

The  plan  followed  in  the  treatment  of  this  case  is  one 
which  we  think  will  admit  of  quite  universal  application.  It. 
is  to  accomplish  : 

1st.  Expansion  of 
the  superior  arch 
anteriorly;  2nd. 

Contraction  of  the 
inferior  arch  ante¬ 
riorly  ;  3rd.  The 
retraction  of  the 
inferior  maxilla. 

Fig.  50  shows 
a  view  of  the  upper 
teeth,  with  the  ap- 


Fig.  50. 


44 


plicince  for  expanding  the  arch  anteriorly  in  position.  It  will 
be  seen  that  by  so  doing  space  will  be  gained  for  the  irregular 
incisors  and  erupting  cuspids. 

The  jack-screws  are  soldered  to  clamp  bands  encircling 
the  first  molars,  the  chisel  ends  are  notched  and  engage  a  piece 
of  the  gold  wire  passing  through  delicate  pipes,  soldered  to 
the  lingual  surfaces  of  bands  encircling  the  lateral  incisors  as 
shown. 

The  nuts  were  tightened  every  third  day,  moving  the 
teeth  out  as  far  as  desired,  in  about  three  weeks.  While  this 
was  being  done  the  lower  jaw  was  being  acted  upon,  the  first 
bicuspids  having  been  extracted,  the  lower  incisors  and  cus¬ 
pids  were  moved  backward,  until  the  cuspids  occupied  the 
space  from  which  the  bicuspids  had  been  removed,  as  shown 
in  Fig.  51. 

The  large  traction  screw  being  attached  to  clamp  bands, 

which  encircled 
the  first  lower 
molars,  and  the 
angles  of  which 
were  hooked  into 
small  staples  sold¬ 
ered  to  bands 
upon  the  distal 
angles  o  f  the 
cuspids,  while  a 
Fig.  51.  piece  of  the  gold 

wire  attached  by  solder  connected  these  bands  and  passed  in 
front  of  the  incisors. 

The  screws  were  assisted  in  moving  the  teeth  backward, 
by  the  headgear,  heavy  elastics  and  traction  bar,  the  socket  in 
the  standard  of  which  engaged  the  little  ball  shown  upon  the 
gold  wire  midway  between  the  bands.  The  object  of  the 
power  so  gained  was  twofold.  First,  to  cause  a  retraction  of 
the  maxilla,  which  we  think  it  did  to  a  noticeable  degree ; 
■second,  to  assist  the  traction  screw  in  moving  back  the  in- 


45 


cisors  and  cuspids,  tliereby  lessening  tlie  danger  of  displacing- 
the  anchor  teeth,  something  always  to  be  guarded  against. 

The  nuts  were  tightened  every  second  day  enough  to- 
occasion  a  slightly  snug  feeling. 

The  results  are  highly  satisfactory,  and  were  accomplished 
quite  rapidly,  and 
with  but  little  in¬ 
convenience  to  the 
patient.  Fig.  52 
shows  case  com¬ 
pleted. 

In  treatino^  some 
of  these  cases  it  may 
be  found  of  advant-  Fig.  52. 

age  to  continue  pressure  upon  the  maxilla  by  attaching  the 
elastics  from  the  headgear  to  hooks  soldered  to  a  swedged 
metallic  cap,  fitting  accurately  to  the  chin,  as  recommended 
by  Dr.  Allen.  The  object  being,  by  continued  pressure,  to^ 
bend  the  jaw  at  the*  angles,  but  only  in  very  young  patients 
do  we  believe  this  even  possible.  We  think  that  in  two 
cases  we  have  succeeded. 

§  12. — Expansion. 

In  cases  where  expansion  of  the  arch  is  necessary,  we 
have  found  this  appliance  to  be  very  valuable,  especially  in 
young  patients,  before  the  teeth  have  become  very  firm  in 
their  sockets  or  where  great  force  is  not  necessary ;  and  espe¬ 
cially  where  the  teeth  are  somewhat  irregularly  arranged  in 
the  arch. 

The  appliance  is  adjusted  the  same  as  described  in  cases 
of  protrusion,  and  shown  in  Fig.  44,  the  head-gear,  traction 
bar  and  delicate  ligatures  of  the  side  being  dispensed  with. 
The  arch  is  bent  to  take  the  shape  in  which  we  wish  the  teeth 
to  be  arranged  at  eornpletion.  The  teeth  to  be  moved  are 
laced  tightly  to  the  arch,  and  the  ligatures  changed  about., 


% 


46 


twice  a  week,  when  it  will  be  found  that  the  force  of  the 
.spring  exerted  by  the  wire  arch  will  soon  move  the  teeth  out¬ 
ward,  causing  them  to  arrange  themselves  to  conform  to  the 
exact  shape  in  which  the  wire  has  been  bent.  And  if  the 
teeth  were  originally  irregular,  they  will  be  compelled  to  take 
regular  positions. 

This  plan,  of  finally  perfecting  the  arrangement  of  the 
teeth  in  the  arch,  I  have  found  of  great  advantage  in  such 
cases  as  represented  in  Figs.  36  and  29,  after  they  have  been 
acted  upon  by  tne  screws  and  levers. 

If  the  arch  is  to  be  expanded  anteriorly  only,  as  in  case 
Fig.  53,  the  bands  for  holding  the  anterior  part  of  the  arch  in 
position  are  placed  upon  the  cuspids,  instead  of  central  inci- 
.sors.  The  incisors  are  now  laced  to  the  arch,  which  is  pre¬ 
vented  from  being  forced  backward  through  the  pipes  on  the 
anchor  teeth  by  closing  the  bore  at  their  distal  ends  with  a 
pair  of  flat-nosed  pliers.  The  spring  of  the  arch  will  soon 
move  the  malposed  teeth  forward.  If  it  is  desired  to  move 
the  arch  forward,  in  order  to  exert  more  pressure,  the  ligatures 
are  cut,  the  arch  removed,  and  two  short  pieces  of  wire  slipped 
into  the  anchor  pipes  and  forced  back  against  the  pinched 
ends,  when  the  arch  is  again  slipped  into  its  former  position, 
and  the  ligatures  replaced  upon  the  incisors. 

This  method 
of  expansion,  while 
so  excellent  in  the 
cases  just  described 
of  younger  patients, 
is  not  so  applicable 
after  the  age  of 
seventeen  or 
e  i  g  h  t  e  e*  n  years, 
when  we  prefer  the 
methods  of  expan¬ 
sion  already  de¬ 
scribed  in  connection  with  set  No.  I. 


47 


In  very  obstinate  cases,  we  have  derived  great  advantage 
by  combining  these  methods,  as  shown  in  Fig.  49. 

An  excellentway  of  performing  rotation  of  a  tooth,  not 
requiring  much  force,  is  to  encircle  the  tooth  with  a  band, 
and  solder  a  spur  upon  the  lingual  corner,  requiring  to  be 
moved  outward.  A  ligature  is  now  passed  around  the  wire 
arch  and  spur,  twice,  and  securely  tied.  It  should  be  renewed 
vdcc  a  week,  or  a  rubber  wedge  drawn  between  the  arch  and 
lingual  surface  of  the  tooth,  which  will  intensify  the  pressure 
for  two  or  three  days  longer. 

§  13. — Outward. 

A  tooth  requiring  to  be  moved  out  of  inlock,  where 
great  force  is  not  required,  may  be  easily  accomplished  with 
this  appliance  by  tightly  lacing  it  to  the  wire  arch,  and  occa¬ 
sionally  renewing  the  ligatures,  or  making  use  of  the  rubber 
wedges,  which  are  drawn  between  the  lingual  surfaces  of  the 
adjoining  teeth  and  wire  arch. 

§  14. — Elongation. 

The  movement  of  elongation  may  also  be  performed  with 
this  appliance  by  firmly  tying  a  ligature  about  the  tooth  to  be 
moved,  or  a  spur  cemented  into  the  same,  and  again  firmly 
tied  to  the  wire  arch.  The  spring  of  the  arch  thus  being 
made  to  exert  force  in  moving  the  tooth  downward  to  the  de¬ 
sired  position. 

§  15. — Inward. 

An  outstanding  tooth  may  be  readily  forced  inward,  into 
the  line  of  the  arch,  by  drawing  a  rubber  wedge  between  it 
and  the  wire  arch,  and  firmly  lacing  the  adjoining  teeth  to  the 
arch. 


CHAPTEE  III. 


•  Final  Suggestions. 

First. — Before  beginning  the  treatment  of  a  case,  have 
a  clear  conception  of  what  is  necessary.  This  can  only  be 
done  by  a  carefnl  study  of  both  models  and  natural  teeth, 
facial  expression,  history,  etc. 

Second. — Have  regular  times  for  seeing  your  patient ; 
be  punctual  yourself  and  insist  upon  punctuality  from  the 
patient,  and  always  carefully  compare  the  original  models  at 
each  sitting. 

Third. — Exercise  such  care  and  judgment  in  the  adjust¬ 
ment  of  the  appliance  that  delays  from  slipping,  breaking  or 
changes  will  be  unnecessary. 

Fourth. — The  best  result  in  moving  a  tooth  is  only 
obtained  by  recognizing  the  regular  and  proper  amount  of 
force  necessary  to  stimulate  absorption.  The  habit  of  apply¬ 
ing  a  great  amount  of  force  at  irregular  intervals  serves  only 
to  defeat  the  object  to  be  gained,  for  it  retards  the  process  of 
absorption,  causes  unnecessary  pain,  provokes  inflammation, 
thereby  endangering  the  life  of  the  pulp.  It  also  strains  the 
appliance,  causing  much  delay  and  pain  to  the  patient  in  re¬ 
pairing  the  same. 

Fifth. — If  the  screw  is  being  used  in  the  movement  of  a 
tooth,  and  the  patient  be  an  intelligent  one,  he  may  be  pro¬ 
vided  with  a  wrench,  and  instructed  to  tighten  the  nut  morn¬ 
ing  and  evening,  thus  greatly  economizing  the  time  of  both 
patient  and  operator ;  yet  the  patient  should  be  seen  at  regular 
intervals ;  usually  twice  a  week  will  be  sufficient. 

48 


49 


Sixth. — It  is  doubly  important  tbat  the  patient  shall 
observe  care  in  brushing  and  cleansing  the  teeth  while  wear¬ 
ing  these  regulating  appliances,  and  we  believe  the  best  den¬ 
tifrice  to  be  used  for  this  purpose  is  prepared  chalk,  followed 
by  castile  soap ;  and  if  the  appliances  are  kept  properly 
cleansed,  they  will  take  on  a  beautiful  bronze  color,  far  more 
pleasing  to  the  appearance  than  when  made  of  gold,  besides 
possessing  much  greater  strength. 

Seventh. — In  adopting  this  system  the  operator  should 
study  carefully,  and  thoroughly  familiarize  himself  with  the 
names  and  uses  of  all  the  parts  of  these  appliances,  and,  after 
a  little  experience,  he  will  be  able  to  readily  apply  them  to 
any  case,  for  the  system  is  complete  within  itself. 

It  is  needless  to  say  the  rubber  plate  has  no  place  in  this 
system.  We  believe  that  it  should  be  a  relic  of  the  past. 
The  only  instance  where  we  make  use  of  a  plate  in  any  form 
is  a  neatly -fitting  skeleton  plate  made  of  aluminum,  and 
swaged  to  fit  the  roof  of  the  mouth,  after  the  arch  has  been 
expanded  and  used  as  a  retainer. 

Eighth. — The  wire  arch  in  Ho.  2  Set  is  made  to  contain 
all  the  spring  possible.  It  is,  therefore,  necessarily  quite 
hard,  and  may  be  broken  ;  consequently,  care  should  be  taken 
in  bending  to  the  desired  shape.  It  is  made  long  enough  to 
encircle  the  largest  arch,  necessitating  clipping  off  the  ends 
when  used  in  circling;  smaller  ones. 

O 

The  three  small  pipes  found  on  it  are  held  in  position  by 
means  of  a  soft  solder  :  should  any  of  these  become  loosened, 
they  should  be  resoldered,  being  careful  to  not  apply  more 
heat  than  necessary  in  melting  the  solder,-  or  the  temper  in 
the  arch  will  be  destroyed. 

Ninth, — In  applying  the  jack-screw,  the  sheath  should 
always  be  used  as  long  as  possible,  turning  the  nut  close  up 
to  the  chisel  end  of  the  screw  before  cutting  the  sheath  to  the 
desired  length. 


50 


Tenth. — In  soldering  the  attachment  to  the  band,  we 
have  fonnd  the  best  plan  is  to  first  slightly  fuse  the  solder 
upon  the  band,  then  holding  the  piece  to  be  united  in  contact 
with  it,  and  again  applying  heat  sufficient  to  unite  them.  If 
the  piece  be  one  of  the  pipes,  an  easy  way  of  holding  it  is  by 
passing  the  point  of  an  old  excavator  into  the  bore,  holding 
the  ba'nd  with  a  |)air  of  pliers.  A  little  experience  will  enable 
the  operator  to  make  any  of  these  attachments,  and  adjust  the 
appliance  in  a  very  few  minutes.  Never  use  more  solder 

than  is  necessary,  or  apply  heat  enough  to  burn  the  bands. 

§ 

Eleventh. — After  the  appliance  has  been  adjusted,  the 
surplus  cement  should  be  removed  and  the  appliance  polished 
with  pumice,  and  burnished. 

Twelfth. — We  believe  there  is  an  impression  among  a 
large  number  of  dentists  that  the  treatment  of  irregularities 
should  be  deferred  until  after  the  age  of  fifteen  or  thereabouts. 
But  we  are  convinced  that  the  impression  is  erroneous  and 
fruitful  of  much  harm,  for  by  this  time  many  cases  have  be¬ 
come  complex  and  exceedingly  difficult  to  treat,  and  leaving 
results  which  it  is  impossible  to  eradicate. 

I  believe  the  best  time  to  begin  the  treatment  is  as  soon 
as  the  appearances  of  irregularity  are  manifest ;  then,  with 
delicate  and  simple  appliances,  gradually  assist  the  tooth  to 
take  its  natural  position.  We  would  not  be  understood  as 
needlessly  interfering  in  those  cases  where  it  is  apparent  that 
nature  will  correct  the  deformity  unaided.  But  we  refer  more 
especially  to  the  inlocked,  twisted  and  overlapped  condition, 
which  usually  becomes  worse  and  complicates  those  to  be 
erupted. 

A  few  days  with  a  proper  appliance  will  often  accomplish 
what  it  may  require  many  months  if  left  until  the  whole 
dental  apparatus  is  involved. 

The  author’s  favorite  device  for  these  specially  early 
cases  is  shown  in  cut.  Fig.  50.  It  is  so  simple  and  delicate 
that  it  will  not  be  objected  to  by  the  little  patient.  It  consists 


51 


of  a  pipe  soldered  perpendicularly  to  the  side  of  one  of  the 
clamp  bands,  into  which  is  hooked  a  piece’  of 
the  gold  wire,  which  is  swung  around  and 
allowed  to  rest  against  some  suitable  tooth, 
to  assist  the  anchor  tooth,  and  a  rubber  liga¬ 
ture  slipped  over  it. 

Thirteenth. — In  using  the  No.  2  appli¬ 
ance  in  the  retraction  of  protruding  teeth,  the 
teeth  will  sometimes  show  a  tendency  to 
bunch  or  overlap,  which  may  be  remedied  by 
lacing  them  firmly  to  the  wire  arch,  or  lacing 
them  as  directed  for  performing  rotation  with  54. 

the  No.  2  appliance. 

And,  again,  some  of  the  teeth  may  tend  to  elongate, 
which  should  be  prevented  by  encircling  with  bands  having 
suitable  niches,  in  which  rests  the  wire  arch,  the  same  as  those 
already  encircling  the  central  incisors ;  or  the  bands  may  be 
removed  from  the  central  incisors  and  pressure  transferred  to 
the  elongating  teeth  by  similar  bands. 

Fourteenth. — In  making  the  attachments,  the  pipes 
should  always  be  flattened,  with  a  round  file,  at  the  point  of 
contact,  thus  making  the  attachment  stronger  and  easier  to 
accomplish,  as  well  as  the  appliance  more  compact.  Always 
carefully  avoid  applying  heat  to  either  the  jack  or  traction 
screws  proper,  or  their  temper  will  be  ruined. 

Finally,  we  believe,  after  thoroughly  understanding  this 
system,  the  operator  will  be  enabled,  in  every  instance,  to  form 
a  combination  with  these  appliance  which  will  enable  him 
to  perform  the  movement  of  a  tooth  more  easily  than  by  any 
other  appliances  yet  devised,  and  we  invite  comparison. 

EDANAKD  H.  ANGLE, 

No.  13  Syndicate  Block, 

Minneapolis,  Minn. 

October  10th,  1892. 


/ 


DR,  TEAGUE^S  IMPRESSION  COMPOUND. 


A  Substitute  for  Plaster  in  All  Cases, 

but  especially  advantageous  where  a  die  is  wanted  for  the 
swaging  of  a  plate. 

The  following  points  of  superiority  over  plaster  as  an 
impression  material  will  appeal  forcibly  to  every  practitioner : 


First. — The  compound  when  mixed  possesses  a  smooth  and 
oily  quality,  which  allows  it  to  spread  freely  and  evenly  over 
the  surface  against  which  it  is  pressed,  and  into  the  spaces 
between  the  teeth,  or  fissures  in  the  crowns. 

Second. — It  will  not  adhere  to  the  teeth,  as  is  so  frequently 
the  complaint  with  piaster,  and  when  removed  from  the  mouth 
it  presents  a  most  perfect  counterpart  on  a  smooth,  glossy  sur¬ 
face,  a  result  not  possibly  attainable  with  plaster. 

Third. — In  separating  the  impression  from  the  plaster 
model  the  operation  is  greatly  facilitated  because  of  the  con¬ 
trast  of  color  (which  is  pink),  with  white  model,  greatly  lessen¬ 
ing  the  liability  to  cut  or  scar  it. 

Fourth. — Its  taste  is  less  unpleasant  to  the  patient,  advant- 
ao-es  of  which  feature  it  is  needless  to  comment  on. 

o 

Fifth. — ^Its  use  entirely  dispenses  with  moulding  sand,  and 
all  the  vexations  and  difficulties  incident  to  the  making  of  a 
perfect  die  by  the  old  method,  and  the  results  are  accurate, 
as  well  as  easily  obtained,  because  the  die  is  made  from  the 
impression  direct,  as  it  is  removed  from  the  mouth.  There 
is  no  making  of  a  plaster  model,  building  up  here  and  taking 
off  there,  filling  depressions,  making  cores,  varnishing,  etc.,etc.^ 
as  is  necessary  in  making  a  zinc  die,  which  at  best,  cannot  be 
perfect  when  done.  There  is  but  the  simple  operation  requiring 
little  more  time  than  making  a  plaster  model,  and  when  cast,  a 
model  is  obtained  with  every  line,  undercut,  tooth  and  rugae 
sharp,  distinct  and  SMOOTH. 

Sixth. — tt  has  no  superior  as  an  investment  compound. 


PRICES. 


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WILMINGTON. 


DR.  E.  H.  ANGLE’S 

UPPER  IMPRESSION  TRAYS 

For  Taking  Full  Dentures. 

Dr.  Angfle  says;— “I  find  the  Impression  Cups  for  sale  at  the  different  depots  are  all 
incorrect  and  ill-adapted  to  the  purpose  of  obtaining  impressions  of  a  jaw  containing  full 
dentures.  The  few  sizes  of  Cups,  herewith  represented,  will  obviate  the  difficulty  of  taking 
impressions  high  up  or  low  down.” 

Dr.  Angle  especially  recommends  these  trays  for  the  taking  of  impressions 
in  regulating  cases. 

Price . each,  35  Cents. 


IV 


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For  Taking  Full  Dentures. 

Price . each,  35  Cents. 


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W|- 


VI 


VII 


CEMENT  SPATULAS. 


Each  of  these  styles  are  made  thin,  medium  and  thick  blades.  State  which 
you  wish. 

Price,  Nos.  1,  2,  3  and  4,  Octagon  File-Cut  Handles, 
vni  Nickel-plated. . . . each,  25  cents. 


CEMENT  SPATULAS. 


Price,  No.  5,  Dr.  H.  Weston’s . 50  cents. 

“  “  6,  “  J.  F.  Flagg’s,  Nickel-plated . 25  “ 

“  “  7,  “  C.  N.  Peirce’s,  “  . 25  “ 

“  “  8,  “  Houghton’s  “  . 75  “  ix 


The  Dentists  Library. 


BOOKS  WHICH  EVERY  DOCTOR  OUGHT  TO  HAVE  AND  USE. 


Anatomy  of  the  Human  Teeth. 

By  G.  V.  Black,  M.D.,  D.D.S.  Second  Edition. 

To  find  a  dentist  without  this  Anatomy  would  be  a  curious  discovery 
indeed.  The  second  edition  has  improved  it  still  further.  The 
carefully  executed  illustrations  give  the  work  originality  and  a 
,  high  value. 

Price,  bound  in  Cloth  (post=paid),  $2.50. 

Dental  Jurisprudence. 

By  W.  F.  Rlhfuss,  D.D.S.,  of  Philadelphia. 

The  book  marks  an  epoch  in  the  Dental  world.  Every  dentist  must 
study  his  own,  as  well  as  his  patients’  rights,  in  order  to  avoid 
trouble ;  and  this  book  furnishes  all  the  necessary  information. 
Besides,  it  gives  the  laws  regulating  dentistry  wherever  such  laws 
exist. 

Price,  bound  in  Cloth  (post=paid),  $2.50;  Half  Morocco,  $3.50. 

567  Useful  Hints  for  the  Busy  Dentist. 

By  W.  H.  STEFLE,  D.D.S. 

The  young  practitioner  or  student,  as  well  as  the  full-fledged  busy 
dentist,  will  find  in  this  valuable  work  a  rich  mine  studded  with 
the  solid  results  of  the  most  varied-  experience  of  nearly  all  the 
best  representatives  of  dental  science,  literature  and  art.  It  is  a 
helpful  reference  book  of  great  value. 

Price,  boun-d  in  Cloth  (post=paid),  $2.50. 

The  Student’s  Manual  and 

Hand=book  for  the  Dental  Laboratory. 

By  L.  P.  Haskell,  D.D.S.  Second  Edition. 

The  first  edition  having  been  quickly  exhausted  by  a  heavy  demand 
from  so  many  colleges,  a  second  edition,  revised,  enlarged  and 
fully  illustrated,  is  now  presented.  There  is  an  important  Appen¬ 
dix  in  which  Dr.  E.  H.  Angle  describes  his  “  System  of  Appliances 
for  Correcting  Irregularities  of  the  Teeth,”  making  the  book  far 
more  valuable  than  its  price,  which  is  only. 

Bound  in  Cloth  (post=paid),  $1.50. 

Chart  of  the  Typical  Forms  of 
Constitutional  Irregularities  of  the  Teeth. 

By  Eugene  S.  Talbot,  M.D,,  D.D.S. 

16  lithographic  plates,  10x12  inches,  Price,  $2.50. 

Those  who  would  make  themselves  familiar  with  these  forms  of  irregu¬ 
larities  of  the  superior  and  inferior  maxilla  can  have  no  better 
guide  than  this  chart,  and  by  this  object  lesson  will  be  able  to 
follow  the  text  of  this  author  more  intelligently. 

— International  Dental  Journal. 


X 


The  Dentists  Library. 

(CONTINUED.) 

Angfle’s  System  of  Regulation  of  the  Teeth. 

By  Edward  H.  Angle,  D.D.S.  Third  Edition. 

The  unprecedented  success  of  Dr.  Angle’s  “Appliances  for  the  Regu¬ 
lation  and  Retention  of  the  Teeth,”  has  compelled  the  author  to 
again  revise  and  enlarge  the  popular  pamphlet  containing  the  full 
description  of  his  superior  system.  The  numerous  new  cuts  are 
executed  in  the  most  artistic  manner,  and  the  pamphlet  is  gotten 
up  as  neatly  as  possible.  Every  dentist  ought  to  have  this  uselul 
pamphlet. 

Price,  paper  cover,  75c. 

Dental  Science. 

Questions  and  Answers  on  Dental  Materia  Medica,  Dental  Physiology, 
Dental  Pathology  and  Therapeutics. 

By  Euman  C.  Ingkrsoll,  A.M.,  D.D.S.  Second  Edition. 

Students,  as  well  as  dentists,  have  appreciated  the  concise  and  clear 
manner  in  which  the  fundamental  facts  of  dental  science  have 
been  presented  in  this  valuable  work.  It  is  the  result  of  30  years’ 
experience  at  the  operating  chair. 

Price,  bound  in  Cloth  (post=paid),  $2.00. 

Letters  from  a  ITother  to  a  Mother  on 
the  Formation,  Growth  and  Care  of  Teeth. 

By  the  wife  of  a  dentist,  Mrs.  M.  W.  J.  Third  Edition. 

“The  fathers  have  eaten  sour  grapes,  and  the  children’s  teeth  are  set  on 
edge,”  laments  Jeremiah,  and  this  valuable  little  book  shows  how 
to  prevent  the  children’s  teeth  from  becoming  a  curse  rather  than 
a  blessing  to  the  coming  generation.  It  ought  to  be  placed  in  the 
hands  of  every  intelligent  mother.  This  edition  has  been  published, 
by  request,  as  per  resolution  offered  in  Southern  Dental  Associa¬ 
tion.  Illustrated.  Price,  bound  in  Cloth,  50c. ;  Paper,  25c. 

Quantitative  prices  given  on  application. 

The  Teeth. 

50nE  PLAIN  FACTS  REGARDING  THE  TEETH. 

By  T.  B.  Welch,  M.D., 

With  suggestions  concerning  their  character ;  their  treatment  during; 
eruption  ;  their  preservation  and  restoration  to  health  when  dis¬ 
eased  ;  and  their  substitution  by  artificial  teeth  when  lost.  The 
following  prices  include  your  name  and  address  on  the  cover  page,, 
preceded  by  the  words  “  With  Compliments  of.” 

Sample  copies,  6c.;  100,  $3.50;  500,  $15.00;  1,000,  $25.00. 

A  nice  booklet  for  dentists  to  send  to  their  patients  who  shall  not  be 
left  without  “The  Teeth.” 

How  to  Save  ur  Teeth. 

(Ritn  in  simplified  speling,  leterz  markt  acording  to  Worcester.) 

The  attractively  gotten  up  folder  contains  seven  rules  which,  when 
followed,  could  prevent  much  trouble  and  suffering  to  thousands 
of  people  who  don’t  know  how  to  avoid  both. 

Intended  for  distribution  among  your  patients.  Name  and  address  printed 
on  first  page. 

Price;  Sample  copies,  3c.;  500,  $3.50;  1,000,  $5.00. 

The  Wii  .MiNQTON  Dental  M’f^q  Co., 

PUBLISHERS, 

1413  Filbert  Street,  Philadelphia,  Pa. 


XL 


•'P+III^DEUE'HIA 

li  EWY0RK,Ch  ICAGO,WASilIN  GT9/i 

•WlI^I/IGT^,  reEL. 


In  the  preparation  of  Dawson’s  Cement  nothing  is  left  undone 
that  will  by  any  means  improve  the  object  desired — a  perfect  cement 
filling.  All  the  materials  are  the  best,  and  are  pure  and  clean.  The 
compounding  is  done  by  practical  chemists;  the  result  is  known  to 
be  the  best  cement  now  offered  to  the  profession. 

For  six  years  it  has  been  demonstrated  by  practical  workers  in 
plastic  fillings,  that  Dawson’s  Cement  is  unexcelled,  in  that  it  makes 
a  dense  filling  with  a  very  hard  and  smooth  surface.  By  crown  and 
bridge  workers  it  has  been  proven  to  be  the  most  valuable  plastic 
for  such  operations,  being  the  most  indestructible. 

It  stands  all  the  tests  for  a  good  cement,  hardening  quickly,  the 
surface  glazing  at  once,  the  filling  having  a  porcelain-like  feel,  and 
losing  its  acid  taste  in  half  an  hour.  Experience  has  proven  that 
it  stands  the  test  of  time  in  a  satisfactory  manner.  The  liquid  is 
prepared  in  such  manner  that  it  stands  climatic  changes  and  age, 
being  the  most  reliable  in  this  respect.  We  furnish  yellow  and  gray 
powders,  from  which  any  necessary  combination  may  be  made. 

Dawson’s  Cement  is  put  up  in  bottles,  in  which  are  blown  the 
name  of  the  cement  and  our  name,  and  put  up  in  a  package  enclosed 
in  an  engraved  label,  of  which  the  cut  is  a  fac-simile.  Dr.  Dawson’s 
signature  is  on  each  package! 


piaicEs 


Sample  package,  one  color . 

Medium  size  package,  two  colors 


$1.00 


1.50 

2.50 


Large 


i  i 


In  lots  of  one  dozen  at  a  time,  a  discount  of  twenty  per  cent,  from  these  pj^ces. 


DR.  J.  W.  MOFFITT’S 

ANATOMICAL  *  ARTICULATOR. 


This  Articulator  has  its  moveuieiits  corre.spondiiigto  those  of  the  natural 
jaws,  the  arrangement  of  the  lower  to  the  upper  plate  is  such  that  any  false 
position  of  the  bite  may  be  corrected,  and  at  the  same  time  the  arc  of  the 
circle  of  the  lower  jaw  in  relation  to  the  upper  will  be  secured  as  in  the 
mouth,  thus  assuring  a  correct  articulation  without  the  necessity  of  grind¬ 
ing  the  teeth  after  they  are  mounted.  It  is  adapted  to  either  partial  or  full 
cases. 

PRICES. 


Nickel=Dipped . . $1.50 

Polished  and  NickeUplated .  . 2.00 


STANDARD 

ARTICULATOR. 


The  capacity  of  this 
Articulator  is  all  that 
is  necessary.  It  will 
take  single  or  double 
models,  and  admit  of 
any  change  in  articu¬ 
lation  ;  made  entirely 
of  brass,  nicely  fitted. 

PRICES. 

Polished  and  Nickel- 

Plated . $1.25; 

Nickel=Dipped  ...  .85 


“  Keep  Thy  Business, 

and  Thy  Bnsiness  Will  Keep  Thee.' 


These  wise  words  of  Benjamin  Frank¬ 
lin  ought  to  he  the  KEYSTONE  in  the 
arch  of  conduct  of  every  intelli¬ 
gent  dental  practitioner.  The 
latter  is  all  the  time  aware 
of  the  fact  that  it  is  not  his  skill  alone,  which  insures 
success  in  Keeping  up  his  business,  but  also  the 
SUPERIOR  QUALITY  OF  THE  GOODS  USED. 

It  is  for  this  reason  that  we  have  been  favored 
by  dentists  from  all  over  the  country  and  abroad 
with  constantly  increasing  orders  for  our 

Liiiiitai  Porcelain  Teetli 

as  well  as  other  materials  and  appli¬ 
ances  used  in  dentistry. 

Easy  fitting,  ornamental  and  du¬ 
rable,  THE  WILTdlNGTON  TEETH 
are,  so  to  speak,  a  “silent  part¬ 
ner  “  in  the  success  achieved  by 
so  many  dentists  all  the  world 
over ;  and,  how  valuable  the 
gratitude  of  the  patients! 

OUR  ELEGANT  SETS  OF 

PORCELAIN  ^  TEETH 

MAKE  THEIR  LIVES 
WORTH  LIVING. 


THE  WILHINGTOH  DENTAL  M'F'G  CO. 


PHILADELPHIA,  NEW  YORK,  CHICAGO, 

WILMINGTON, 


WASHINGTON, 


-f- 


i 


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